Patient Forms

What to Expect During your Visit

You have been referred to us by another physician, perhaps your internist. You can expect to be here for about an hour on your first visit. Generally, special test or ultrasound exams are not scheduled before your first visit.

You may eat normally before your appointment, unless you are advised otherwise by the gastroenterology staff.

Please Bring With You:

New Patients

Returning Patients

You should bring cash, a check, or credit/debit card to cover any visit co-payments.

At the front desk you will meet with a staff member who will take your new patient packet, confirm your identification and insurance information, give you some papers to put in a box, and ask you to have a seat. A Medical Assistant will then call your name and bring you (generally alone, without your family members) to the “triage” area where she will weigh you, review your medications and allergies, take your temperature, check your heart and blood pressure, and ask you a few questions. Afterwards, any family members can accompany you as the Medical Assistant shows you to the clinic exam room.

The Physician or Nurse Practitioner will meet you and ask detailed questions about your current problems, past medical history, family history, and other pertinent information. The Physician or Nurse Practitioner will then perform a complete exam. Afterwards, there will be a discussion of the plan of care, give you written instructions, possibly order tests (such as blood tests, x-rays, GI procedures or motility tests). You will then be brought to the check-out area where a staff member will answer any questions, collect any required payments, and schedule any tests and appointments.

Downloadable Patient Forms

Please download and print the applicable forms below and read/complete them before your visit with us to speed up your prep time.

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New Patient Packet

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New Patient (Referral)

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Patient Information

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Patient Interview Form

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Patient Portal Letter

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Review of Systems

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HIPAA Authorization

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Medication List

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Fibroscan Referral Form

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Esophageal Motility Referral Form

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Consent for Treatment and Use and Disclosure of Health

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Acknowledgement of Receipt of Privacy Practices

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Notice of Privacy Practice with Addendum

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Office Policy

Request an Appointment

Complete our online form to request an appointment or consultation with one of our specialists.