New Patient Forms

If it is your first visit to one of our Alabama locations, please download our new patient form. Please fill out this form and bring it in with you at the time of your appointment.

Alabama

New Patient Form

Notice of Privacy Practices

Existing Patient

Alabama
Existing Patient Form

Refer a Patient

Alabama
Referral Form

Colonoscopy Prep Forms

All patients should read and follow the instructions for both the Colonoscopy Info Sheet and Low Residue Diet

Colonoscopy Information Sheet
Low Residue Diet (start this diet 3 days BEFORE your procedure)

Please follow the specific prep your provider has prescribed for you.

2-Day MiraLax 
Clenpiq 
Plenvu 
Suflave
Suprep 
Sutab 
Trilyte/GoLytely Split Dose  

Medical Records Request

Medical record requests are fulfilled by Medicopy.

Please follow this link to begin a request via Medicopy.