Patient Forms

If you are a new patient coming to our office for the initial appointment or you are a patient who has not been to our office in one year or more, you will be asked in the form of an email to provide your information prior to your appointment using a link provided.  If you are unable to provide the information before your appointment, you must provide the information on our electronic tablet/pad when you arrive.

For patients scheduled for repeat colonoscopy, print the Patient Information Packet (see below).  Please fill out the requested information and return them to our office by mail at least one week prior to scheduled colonoscopy.

For patients needing instructions for preparation for colonoscopy, print one of the following forms; ClenPiq Preparation, Miralax, or GoLytely / TriLyte Preparation.

If there is any confusion about the prep to be used, please contact our office (256) 533- 6070.

Also, for patients having colonoscopy, please review our Colonoscopy Overview sheet prior to colonoscopy. Your physician will answer any questions you may have concerning colonoscopy prior to the procedure.

All patients should review Insurance and Other Information.

Click below to download patient forms.*

Patient Information Packet:

• Patient Information Form
• Medical information
• Consent Form
• Notice of Privacy Practices

Instructions for preparation for Colonoscopy:

• ClenPiq
• Magnesium Citrate Prep
• Miralax Prep
• TriLyte

Form to request a copy of your medical records for yourself or a different physician:

• Records Release