A Special Dedication in the Field of General Surgery.

Patient Testimonials

I've been a patient of Dr. Kubicka's at Maple Grove Surgical Specialists for some time now.  The family like atmosphere makes this clinic stand out from the others.  I highly recommend Maple Grove Surgical Specialists for the personal and professional care they provide. 
- Arnie Klukas

Patient Forms

We appreciate and value your time, so we've created downloadable forms in order to expedite your visit with us. Download and print the forms below and fill them out. Coming prepared will save you some time on the day of your visit!

Please click on the links below to download and print your forms. Completion of each of these forms is required in order to better serve you as a patient. 

Credit Policy

New Patient Registration

Notice of Privacy Practices

Release of Information

Click here to download Adobe ReaderPDF documents on this page require Adobe Reader to view. If you already have Adobe Reader installed on your computer, you do not need to install it again.
                                                                To download, Click Here