For Providers and Referring Physicians

Forms for Your Patients

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• Consent Prior to Esophagogastroduodenoscopy

• Consent Prior to Gastrointestinal Colonoscopy

• Consent Prior to Gastrointestinal Endoscopy

• Consent Prior to Gastrointestinal Hemorrhoidal Treatment

• Financial Policy

• Information Regarding Gastrointestinal Endoscopy

• Language Services

• New Patient Registration Form / Map / Medical History

• Privacy Practices, Rights, Responsibilities

• Release of Information

 

The following maps will open as PDFs suitable for printing in black and white on 8.5" x 11" paper

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These 1-page maps contain regional offices, written and graphic directions, contact information and appointment areas for your convenience. Print and mark up the appropriate map for your referred patient.

• The Center for Digestive Wellness Map

• Johnson City Office Map

• Elizabethton Map

• Erwin Map

• Mountain City Office Map

• Composite Map of Several Locations

 

Brochures

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Providers, we would be happy to supply you with printed brochures as a courtesy to you and your patients. Please contact our administrator at the Center for Digestive Wellness.

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Please click here for a PDF of our brochure "lite" in color. It has been re-sized to print on 8.5" x 11" paper.

Please click here for a PDF of our brochure "lite" in black and white. It has been re-sized to print on 8.5" x 11" paper.