Office Practice Policies

Whether you are new to our practice or have been a patient of ours for some time, below is a list our most recently updated Practice Policies. When first becoming a patient of our practice you will be asked to review and sign the Practice Policies through our electronic check-in-system. Once acknowledged and signed, the electronic Practice Policy will automatically record itself in your Medical Record. Some Practice Policies require new acknowledgments and signatures every year.

• Office Visit Policies
• Privacy Form (HIPAA)
• Patient Bill of Rights and Responsibilities
• Consent for E-mail Correspondence and Electronic Communication
• Formulary Benefits Data Consent
• Surgical Center Policies
• Surgical Center Rights and Responsibilities

Office Practice Forms

Below is a list of our most recently updated Practice Forms: Questionnaires are usually requested by our staff due to the type of condition you have; please print and complete and bring with you to your appointment. Other Practice Forms may be mailed or faxed to our office.

• Constipation Questionnaire
• Fecal Incontinence Questionnaire
• Medical Records-Authorization & Release