Health Services 2

Colon & Digestive Health Specialists Eastside Endoscopy Center

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Appoinments

Patient Demographic and HIPAA Form

Patient Demographic and HIPAA

Authorization to Release Medical Information Form

Authorization to Release Medical Information

Preparation Instructions Forms

Clenpiq & Suprep prep Instructions (diabetics)_(Piedmont Rockdale)

Clenpiq & Suprep prep Instructions for diabetics

Clenpiq instructions

EGD prep Instructions

Miralax 2 DAYS BEFORE

Miralax Prep Instructions (diabetics)

Miralax Prep Instructions (diabetics)_(Piedmont Rockdale)

Miralax Prep Instructions (Piedmont Rockdale)

Miralax Prep Instructions

Plenvu Preparation Instructions

Sigmoidoscopy Prep Instructions

Suprep & Clenpiq prep Instructions (Piedmont Rockdale)

Suprep & Clenpiq prep Instructions

Suprep instructions

Sutab Instructions

Consent Forms

(FOR INFORMATION PURPOSES ONLY)

AYSA Assignment of Benefits

COLONOSCOPY Consent

Consent for ANESTHESIA

EGD Consent

FINANCIAL Information & Consent

PREGNANCY TESTING Refusal Consent

PRIVACY CONTACT Information

SIGMOIDOSCOPY Consent

Declaration of the Healthcare Practice Form

(FOR INFORMATION PURPOSES ONLY)

Patient Rights and Responsibilities and other info

Colon

For Life-Threatening Emergencies Call 911

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(770) 922-7000

Our location

Colon & Digestive
Health Specialists
1805 Honey Creek
Commons,
Ste B, Conyers GA
30013

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Monday - Friday : 7:30am – 4:00 pm
Saturday & Sunday - CLOSED

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