This form may be used by Patients to give Gastroenterologists, P.C. permission to obtain their medical records from other providers or facilities. Please print this form then fill it out and return it to our office by mail or fax (319-366-0795).
Medication: Please bring all medications you are taking, or a complete list, with you to your scheduled appointment.
Prescription Refills: Please call during office hours only for prescription refills.
No Smoking: As a safeguard to patient's health, smoking is not allowed in our office.
Confidentiality: Our office complies with federal and state law concerning confidentiality of medical information including the federal HIPAA privacy rule. Your medical information will be released only consistent with these laws and regulations.
Payment Policies: We file all insurance for our patients. Please be sure to send us a copy of your insurance card before your appointment or present it at the time of your office visit. We accept assignment on Medicare and participate with Blue Cross and Blue Shield, and the Cedar Rapids PHO. When payment is received from your insurance, we will bill you for the balance due. If your insurance requires prior approval by your family physician before your visit here, please call your family doctor.