Patient Forms

Patient resources and preparation for your visit.

Patient Forms

Your first visit to our office will be in the form of a consultation. The physician will meet with you to discuss your gastrointestinal issues, medical and social history, and to perform a physical examination. They will then discuss with you a treatment plan and course of action. If you have any questions regarding the Patient Forms feel free to contact our main office at (516) 785-6800.

Please download and print all of the forms below. Be sure to complete all pages in their entirety, including signatures and all necessary fields, and bring with you to your appointment.

Patient Forms

Do not forget to bring the following items to your appointment:

  • Most current insurance card(s)
  • Driver’s license or photo identification
  • Co-payment in the form of cash, check or credit card
  • A complete listing of your medication, including dosages
  • If you have seen a Gastroenterologist in the past and/or have had prior diagnostic testing done CT scan, x-ray, lab work, etc.), please have those records forwarded to us in advance or bring with you to your appointment.
  • Ensure that our office has received a referral, if necessary, in advance of your appointment.

About Your Visit

The physician will meet with you to discuss your gastrointestinal issues, medical and social history, and to perform a physical examination.

Office Visit