Exhibit 3.315

PAGE 1

     I , JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF DELAWARE, DO HEREBY CERTIFY THE ATTACHED ARE TRUE AND CORRECT COPIES OF ALL DOCUMENTS ON FILE OF “PUTNAM AMBULATORY SURGERY CENTER, LLC” AS RECEIVED AND FILED IN THIS OFFICE.

     THE FOLLOWING DOCUMENTS HAVE BEEN CERTIFIED:

     CERTIFICATE OF FORMATION, FILED THE THIRTIETH DAY OF DECEMBER, A.D. 2004, AT 2:01 O’CLOCK P.M.

     AND I DO HEREBY FURTHER CERTIFY THAT THE AFORESAID CERTIFICATES ARE THE ONLY CERTIFICATES ON RECORD OF THE AFORESAID LIMITED LIABILITY COMPANY, “PUTNAM AMBULATORY SURGERY CENTER, LLC”

		/s/ Jeffrey W. Bullock
		Jeffrey W. Bullock, Secretary of State
3905144 8100H		AUTHENTICATION: 8620240
110292834		DATE: 03-14-11
You may verify this certificate online at corp.delaware.gov/authver.shtml

Certificate of Formation
of
Putnam Ambulatory Surgery Center, LLC

     The undersigned, an authorized natural person, for the purpose of forming a limited liability company, under the provisions and subject to the requirements of the State of Delaware, particularly Chapter 18, Title 6 of the Delaware Code and the acts amendatory thereof and supplemental thereto, and known, identified, and referred to as the Delaware Limited Liability Company Act (the “Act”), hereby certifies that:

     FIRST: The name of the limited liability company is Putnam Ambulatory Surgery Center, LLC (the “Company”).

     SECOND: The address of the registered office and the name and address of the registered agent of the Company required to be maintained by Section 18.104 of the Act is The Corporation Trust Company, Corporation Trust Center, 1209 Orange Street, Wilmington, Delaware 19801.

     IN WITNESS WHEREOF, the undersigned has executed this Certificate of Formation as of December 30, 2004.

By:	/s/ Mary Kim E. Shipp
	Mary Kim E. Shipp
	Authorized Person

State of Delaware

Secretary of State

Division of Corporation

Delivered 02:20 PM 12/30/2004

FILED 02:01 PM 12/30/2004

SRV 040953808 – 3905144 FILE