New Patient Forms

New Patient Form
 Patient Interview Form (To fill out your questionnaire, please log in to the patient portal and click on the questionnaire tab and submit each page.)


Additional Forms

Please find below additional forms from Gastro Health that you may need to reference throughout your care with us.

Notice of Privacy Practices
Authorization to Disclose PHI (Release of Information)
Advanced Directive Policy
Endoscopy Information Brochure
Procedure Billing: What You Need To Know


Procedure Preparation

Patients should read Prep FAQ’s and Instructions prior to a procedure. 

FAQ for Colonoscopy

FAQ for Endoscopy    
Diabetes Medication Instructions - English Diabetes Medication Instructions - Spanish Diabetes Medication Instructions - Vietnamese 


Colonoscopy Prep Forms

Please choose the correct prep based on the care center you go to and the prep brand you were instructed to use. If you have any questions, please reference the endoscopy center webpage where you are having your procedure at or call your Gastro Health care center. 

Care Center Location Colonoscopy Prep Forms

EdmondsKirklandSeattle - FremontSeattle - NorthgateTri-Cities 




Other Procedure and Test Instructions

Care Center Location






At Gastro Health Washington, we take the safety of our patients and staff seriously. Each of our site locations adheres to OSHA (Occupational Safety & Health Administration) Act standards and Washington state laws. Firearms, knives or weapons of any sort are not permitted on our premises. Smoking is not allowed within any of our buildings; a receptionist can direct you to a designated outdoor smoking area that is at least 25 feet from any windows or doorways. We also ask that during your visit you please refrain from cell phone use and put the ringer on silent or vibrate as a courtesy to others. We appreciate your cooperation and help to keep our practice a safe environment for all who visit.