Return to CB Surgical HomeCB Surgical
About UsOur PhysiciansOur ServicesInformation and FormsContact Us
Council Bluffs Surgical Associates
Patient Forms

You will need Adobe Acrobat to view the forms

Patient Registration Packet
Patient Registration Form
Patient Health History Form
Patient Policies
Privacy Notice
Spanish Privacy Notice
Medical Release Form
Spanish Medical Release
Consent to Treat
IQHealth Website
What is Medical Identity Theft
MoviPrep Instructions for Colonoscopy
Gatorade Colonoscopy Preparation

NE Health Information Initiative
NE Health Information Initiative Acknowledgement

IQ Health

Information Links
American Board of Surgery
Patient Education American College of Surgeons Website
Jennie Edmundson Hospital
Council Bluffs Hotels

Michael K. Zlomke, M. D.
Patrick J. Ahrens, M.D.
Eric M. Bendorf, M.D.

Cleo M. Beckham, PA-C

201 Ridge St., Suite 214
Council Bluffs, IA 51503

Copyright © 2009 by Council Bluffs Surgical Associates. All rights reserved.
Revised: 08/11/17 16:26:52 -0500
Website by Graphic Design by Dianne