Patient Forms

Below are the patient forms for Atlanta Gastroenterology Specialists. We recommend that our patients download, complete, and bring the forms with you to your appointment. Completing these forms in advance and in the privacy of your home will help expedite your patient visit.

• Patient Forms Packet (7 pages)
• HIPAA Notice of Privacy Policies - print for your records

Individual Forms

If you need an individual form from the packet above, please choose the form from the list below.

• Patient Questionnaire
• Patient Registration
• Release of Information
• Authorization to Release Medical Records

Fast Access Colonoscopy Form

If you are scheduled for a Fast Access Colonoscopy, please print and complete this form and follow the instructions on the form.

• Medical History Questionnaire for Screening Colonoscopy

Insurance

Atlanta Gastroenterology Specialists participates in most health plans. If a referral is necessary, please provide the information when your appointment is scheduled.

Please check with your provider to ensure there have been no changes in your provider panel. Atlanta Gastroenterology Specialists accepts Medicare and most insurance plans offered in Georgia.

Atlanta Gastroenterology Specialists is an Ambetter provider,
and we are accepting new patients.