al.
logo_left (31K)
title_logo (20K)
phone (8K)
location (2K)

We are conveniently located near St Josephs Hospital.

Click here for directions

office_hours (3K)

Our new office is open:

Monday - Friday
8:30am to 5pm
All Patients seen by appointment.

No show/ Missed Appointment Policy


Office visits without 24 businness hours cancellation notice
$50.00
Outpatient procedures without 48 business hours cancellation notice
$100.00
We strive to confirm/remind you of your appointment 2 days prior as a courtesy. In the case of personal/family emergencies that cause cancellations, fees will be waived.

hospital (4K)

Dr Slezak performs her surgery and colonoscopy at Tampa Outpatient Surgery Center and St. Josephs Hospital, both convienently located just minutes from the office.

Patient Forms

divider_line (1K)

These forms may be filled out online electronically and submitted to our office securely, or you may download them and fill them out manually and bring them to our office at the time of your appointment, whichever is most convenient for you

Feel free to contact the office with any questions.

divider_line (1K)

online_form_icon (6K)
Online Form
All information entered is protected and in compliance with HIPAA.
divider_line (1K)
pdf_icon (40K)
Patient Information

Patient Information Questionnaire.
divider_line (1K)
pdf_icon (40K)
Patient Medical History

Medical History Questionnaire.
divider_line (1K)
pdf_icon (40K)
HIPAA Consent Form

Patient authorization of Protected Health Information for treatment.
divider_line (1K)
pdf_icon (40K)
Assignment of Benefits

This is so that your insurance is able to pay Slezak Surgical Clinic for our services.
divider_line (1K)
pdf_icon (40K)
Patient Self Determination Act

This form is the Self Determination Act Questionnaire to comply with the Omnibus Budget Reconciliation Act of 1990.
divider_line (1K)
bottom_line (1K)

Disclaimer: The information on this site is not medical advice and should not be taken as medical advice. This information should not be used to diagnose or treat a health problem or disease and is in no way meant to be a substitute for professional medical care. Patients and prospective patients should schedule an appointment or consult their own physician if they suspect they have a health condition or serious medical problem.