Forms & Procedure Instructions

The US Food and Drug Administration (FDA) recently issued a voluntary recall on Magnesium Citrate Saline Laxative Oral Solution sold at several major retailers. For more information on this recall, please visit the FDA’s website. Capital Digestive Care offers its patients the ez2go prep kit, which contains a different brand of magnesium citrate that is not impacted by this recall. If you are not using the ez2go prep kit and are having difficulty obtaining magnesium citrate for your pre-procedure preparation, please contact your provider’s office directly for assistance and to discuss other options.

Registration

  • 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
  • Patient Commitment to Safety Attestation (Covid-19)  
    English

Colonoscopy Preparation Instructions

Please read and follow the instructions for the specific prep your provider has prescribed for you. If you are not sure which prep you have been prescribed, please visit your patient portal.

Clear Liquid Diet
Low Residue Diet
HyGieaCare Prep for Colonoscopy
  • HyGieaCare Prep for Colonoscopy  
    English

Other Procedure Preparation Instructions