Please print and fill out only the forms that you are instructed to complete and bring with you to your appointment.
HIPAA GHS Forms:
Acknowledgement Form
Medical Record Release Form
Patient Appointment Representative Form
Privacy Notice Form
HIPAA SASC Forms:
Acknowledgement Form
Medical Record Release Form
Patient Appointment Representative Form
Privacy Notice Form
Brief Privacy Notice Form
GHS General Forms:
Medical History Form
Medication List Form
Patient Registration Form
Professional Service Agreement Form
Gastrointestinal Endoscopy Consent Form
SASC General Forms:
Medication List Form
Patient Rights & Responsibilities Form
Professional Service Agreement Form
Satisfaction Survey Form
Patient Grievance Form
Advance Directives & Living Will Form
Colon Consent Form
EGD Consent Form
Form Charges:
Charges For Disability Forms
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