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eCare Patient Portal



Holy Redeemer
Medical Office Building
1650 Huntingdon Pike, Suite 154
Meadowbrook, PA 19046
Get Directions

Hours
Mon - Fri 8:30am – 4:00pm

 

 

PATIENT FORMS


Welcome to Holy Redeemer Surgical Associates. In order to make your first appointment go as quickly and smoothly as possible, please print and complete the following forms and bring them to your appointment along with your insurance card(s), a photo ID, list of medications, health history and referral if needed. Also, please bring any relevant test results such as ultrasound, MRI and/or CT scans. If you’re a new patient, please arrive 15-20 minutes before your scheduled appointment time.

 

PDF TX-65Patient Information

 

PDF TX-65Authorization to Speak to Another Regarding Medical Care

 

PDF TX-65Consent for Financial Responsibility

 

PDF TX-65General Consent to Treatment

PDF TX-65Authorization for Access or Release of Protected Health Information

 

 

PDF TX-65Standing Consent To External Prescription History

 

 

Payment/copay is expected at the time of your appointment. We accept cash, check, VISA, MasterCard, Discover and American Express. Appointments are required.

 

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eCare Patient Portal



Holy Redeemer
Medical Office Building
1650 Huntingdon Pike, Suite 154
Meadowbrook, PA 19046
Get Directions

Hours
Mon - Fri 8:30am – 4:00pm


MNAP Medical Solutions
9908 E. Roosevelt Boulevard
Philadelphia, PA 19115
Get Directions

 

Hours
Monday 1:00pm – 4:00pm
Tuesday Closed
Wednesday Closed
Thursday 1:30pm – 4:30pm
Friday Closed