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Forms and Preparation Instructions

The following forms have been posted for your convenience. We encourage you to download and complete your registration forms prior to your office visit. This will help us provide you with the most efficient service!

Please Note: We make every effort to keep this information up-to-date, however, forms are subject to change without notice.

Registration Forms

  • Authorization to Release Medical Information Form
    English
  • Billing Category Assignment of Benefits Form
    English
  • Established Patient Registration Packet
    English | Español
  • New Patient Registration Packet
    English | Español
  • Notice of Privacy Practices
    English
  • PIF (Medical History Form)
    English

Procedure Preparation Instructions

Capital Digestive Care does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities.

View Non-Discrimination Policy

Capital Digestive Care provides appropriate auxiliary aids and language assistance services.

View Language Assistance Services

Telehealth Appointments Available

All Capital Digestive Care physicians and advanced practice providers are offering "virtual" visits via telehealth. Call your doctor's office to schedule an appointment. For the health and safety of our patients and staff, we are limiting in-office appointments and endoscopy procedures to patients requiring urgent care. We encourage all individuals to practice everyday preventive actions and social-distancing to help prevent the spread of COVID-19.