Contact Plaza :      971-229-8100       Care@plazaasc.com
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PLAZA Ambulatory Surgery Center LLC
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Patient Documents

Thank you for choosing Plaza Ambulatory Surgery Center to provide your medical needs.

Prior to your scheduled appointment, please complete the following forms and bring with you.

Consent Form
Medication Reconciliation
Advance Directive Fillable

Please review the following information:

Covid-19 Testing
Financial Policy For Surgery
Patients Rights & Responsibilities
General Discharge Instruction

  • 2014 © Plaza Ambulatory Surgery Center
  • 5050 NE Hoyt St., Suite 156, Portland, OR 97213
  • Phone : 971-229-8100
  • Fax : 971-229-8101
  • Email : Care@plazaasc.com
  • Billing Disclosure
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We are committed to protecting the health of our patients, staff, and community. We are taking new precautions due to COVID for patients, and not allowing visitors in the facility at this time. Thank you for your understanding. New precautions we are taking for patients, families, and visitors : Click here