We have provided preregistration forms and privacy notices to help better inform you and prepare you before your office visit.
Patient Registration Forms & Privacy Notices
If you are a new patient, please fill out the registration forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment.
- Patient Registration Form
- Registro de Pacientes y Consentimiento para Tratar
- Medical Records Release
- Patient HIPAA Acknowledgement and Consent
- Consent to treat/financial consent
Gastroenterology prep instructions/forms
- Rectal EUS
- Upper EUS Instructions
- Colonoscopy Instructions (Neff)
- ERCP Instructions
- EGD Instructions
- Colonoscopy Instructions (Shah)
- Colonoscopy instructions (Fakhruddin, Lewis, Schneider, Stein)
- Endoscopy request
Patient Rights & Responsibilities
We respect our patients’ dignity and pride. This document will explain your patient rights and responsibilities. It is part of your patient registration and is an important part of your health care plan.
This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
- Notice of Privacy Practices (provided for you at your first visit)
- Aviso Sobre Las Practicas De Privacidad (proporcionada por usted en su primera visita)