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  Patient Information
 
 

1. We ask that you arrive 15 minutes before your scheduled appointment to allow sufficient time for the check-in process.

2.Please print out and complete the Patient Registration and the Health History forms. The links to these forms are located in the list below.

3.It is important that you bring your insurance card(s), Medicare cards and/or DSHS coupons with you at the time of the appointment. Failure to present your card(s) will release Northwest Gastroenterology Associates from any responsibility for incorrect or untimely filing of contracted claims. Please notify our office if there is any change to your insurance information.

4.Many insurance plans require a written referral from your Primary Care Practitioner. Please call your Primary Care Practitioner’s office to make sure that the referral is completed and in our office at the time of your appointment.
Our
fax number is (425) 462-8021. If we do not have your referral, we may need to reschedule your appointment.

5.If your insurance plan has an office visit co-payment, we will request your co-payment at the time of your visit. We accept cash, checks, Visa and MasterCard.

6.Please bring a list of all medications, prescription and over-the-counter, you are currently taking. To assist our clinical staff in determining your treatment, please contact your Primary Care Practitioner and request they fax us any recent clinic notes, laboratory/radiology tests and results pertaining to your scheduled visit in our office. Our fax number is (425) 462-8021.

If you have any other questions regarding your appointment, please feel free to contact our office at (425) 454-4768. If you need to cancel your appointment, please contact our office at least 24 hours in advance.

Privacy Notice:

We respect your privacy. We will contact you the day before your appointment to confirm your scheduled appointment. Frequently, this requires us to leave a message on an answering machine or voicemail or share it with a family member. If you would prefer that we do not call you with a reminder message, please contact our office.

Patient Forms For Download:

 
 

Eastside Endoscopy Procedure Consent Form

Health History

HIPAA

Medicare Information/Forms

Open Access

Patient Registration

Records Release

 

 
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BravoCapsule EndoscopyColonoscopyEGDEndoscopic UltrasoundERCPFlexible SigmoidoscopyHemorrhoid BandingLiver Biopsy
Colonoscopy PrepsEGD Preps
Edwin J. LaiV.MohanCarol S. MurakamiRoanne R.E. SelingerShie-Pon TzungRobert A WohlmanBobbie Aflatooni
Eastside Endoscopy Procedure  Consent FormHealth HistoryHIPAAMedicare Information/FormsOpen AccessPatient Registration Records Release