GI Associates of SW Florida

Patient Forms and Information

    Click on Forms Below  

•Patient Registration Form -( English ) ( Spanish

•Annual Update Form -( English ) ( Spanish )

•Medication List -( English ) ( Spanish )

•Financial Policy -( English ) ( Spanish )

•No Show/Cx Policy -( English ) ( Spanish )

•Consent to Disclose Information -( English ) ( Spanish )

English ) ( Spanish )

•Request to Release Information Form -( English ) ( Spanish )

•Request to Obtain Information Form -( English ) ( Spanish )

•Employee Recognition Ballot -( English ) ( Spanish )

​•Colonoscopy-What you need to know -( English ) ( Spanish )

​•Notice of Non-Discrimination & Accessibility-( English ) ( Spanish )

Your First Appointment

Please arrive 15-30 minutes early so that we can complete your initial paperwork. Also, please bring the following: 

•Patient's insurance card  •Patient's Photo ID 

•List of current prescriptions and/or over-the-counter medication, including dose and frequency  •Information about patient's medical & surgical history 

•Recent test results, x-rays, or relevant records 

Hospitals

Our physicians are on staff at the following medical facilities: 

Gulf Coast Medical Center  Cape Coral Hospital

We do not attend or admit patients at the following medical facilities; Only Consulting Privileges at:
Lee Memorial Cleveland Campus ​• Health Park Medical Center

Click To View our  Privacy Practice Click To Request to  Restrict Your Information Click To Request to  Correct or Amend Your Information

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