--- title: Patient Forms | Gastroenterology Associates description: Get your medical history questionnaire and new patient forms for Gastroenterology Associates. image: https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Images/LICDH_OGImage1.jpg --- English | [Español](https://www.ligastrohealth.com/es/patient-forms/) [![Logo](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Images/GA-Logo_BlueWhite2b.png)](https://www.ligastrohealth.com/) [![Logo](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Images/GA-Logo_BlueBlack2b.png)](https://www.ligastrohealth.com/) ![Patient Forms](https://www.ligastrohealth.com/hs-fs/hubfs/Licdh%20January2018%20Theme/Images/LICDH_TitleHero.jpg?width=1920&height=445&name=LICDH_TitleHero.jpg) # Patient Forms ## New Patient Forms If you have made your initial appointment, you can preregister by clicking on the links below to download our New Patient Forms. Please print and complete the forms prior to your arrival. This will help to speed up the new patient registration process. - [Demographic Form](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/Demographic%20Form.pdf) - [Contact Consent Form](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/Contact%20Consent%20Form.pdf) ![Healthy adults walking together on the beach](https://www.ligastrohealth.com/hs-fs/hubfs/Licdh%20January2018%20Theme/Images/LICDH_PatientForms1.jpg?width=1118&height=513&name=LICDH_PatientForms1.jpg)   ---     ## LICDH: Procedure Information #### Prior to Your Procedure - It is VERY important that you arrange for someone to drive you home. - Make sure you read the [procedure instructions](https://www.ligastrohealth.com/procedure-instructions/) in advance and be sure to contact your physician if you have any questions. - Be sure to leave all jewelry and valuables at home. #### Day of Your Procedure - Please arrive for your procedure 45 minutes prior to your scheduled time. - Please bring your insurance card, photo ID, eye-glasses and your medication sheet.   #### After Your Procedure - The approximate duration of your stay at LICDH is 3 hours from the time of your arrival to the time of your discharge. - Your doctor will discuss the findings with you after your examination. It is recommended that a family member or close friend be present during this discussion. - If biopsy or polyp specimens have been sent to a pathologist, please contact your physician 10 days after your procedure and he/she will discuss the results with you. [Learn More About Procedures](https://www.ligastrohealth.com/procedures/) ## LICDH: Procedure Consent Forms #### Rights, Privacy, and Financial Consents - [Non-Discrimination Statement](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_NondiscriminationStatementTranslatedResouces.pdf) - [Notice of Privacy Practices](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_NoticeOfPrivacyPractices.pdf) - [Patient Acknowledgement of HIPPA](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_PatientAcknowledgementOfHIPPA.pdf) - [Patient Acknowledgement of Financial Responsibility](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_PatientFinancialResponsibility.pdf) - [Patient Rights and Responsibilities](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_PatientRightsAndResponsibilitiesNYS.pdf) #### Procedure Consents - [Informed Consent for Anesthesia](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_Anaesthesia.pdf) - [Informed Consent for Colonoscopy](https://www.ligastrohealth.com/wp-content/uploads/2016/11/LICDH_ConsentForms_Colonoscopy.pdf) - [Informed Consent for Upper Endoscopy](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_EGD.pdf) - [Informed Consent for Hemorrhoid Energy Treatment (HET)](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_HET.pdf) - [Informed Consent for Sigmoidoscopy](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_SIGMOID.pdf) #### Consent Forms (Spanish) - [Consentimiento del Paciente y Acuse de Recibo de Prácticas de Privacidad](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentFormsSpanish_AcknowledgementOfHIPPA.pdf) - [Aceptación De Responsabilidad Financiera Del Paciente](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentFormsSpanish_PatientResponsibility.pdf) - [Servicios de Anestesia](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentFormsSpanish_Anaesthesia.pdf) - [Servicios de Colonoscopia](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentFormsSpanish_Colonoscopy.pdf) - [Endoscopia Digestiva Alta](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentFormsSpanish_EGD.pdf) - [Sigmoidoscopia](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Pdf/LICDH_ConsentForms_SIGMOID%20(1).pdf) **GASTROENTEROLOGY ASSOCIATES** 106 Charles Lindbergh Blvd., Suite B, Mitchel Field, Uniondale, NY 11553 ** Phone: 516.248.3737 ** Fax: 866.540-1163 **LONG ISLAND CENTER FOR DIGESTIVE HEALTH** 106 Charles Lindbergh Blvd., Suite C, Mitchel Field, Uniondale, NY 11553 ** Phone: 516.794.1868 ** Fax: 516.794.1627 [ Gastroenterology Associates on Facebook ](https://www.facebook.com/pages/Gastroenterology-Associates/285209374890717)[ Gastroenterology Associates on Twitter ](http://twitter.com/GIAssociatesNY) ### ABOUT - [Our Doctors](https://www.ligastrohealth.com/our-doctors/) - [Our Philosophy](https://www.ligastrohealth.com/our-philosophy/) - [Testimonials](https://www.ligastrohealth.com/testimonials/) - [Blog](https://www.ligastrohealth.com/blog/) ### LICDH - [About LICDH](https://www.ligastrohealth.com/licdh/) - [Procedure Information & Consent Forms](https://www.ligastrohealth.com/licdh/procedure-information) - [Physicians & Staff](https://www.ligastrohealth.com/licdh/physicians) ### CONDITIONS - [Colon Cancer](https://www.ligastrohealth.com/colon-cancer/) - [Heartburn and Acid Reflux](https://www.ligastrohealth.com/gerd/) - [Inflammatory Bowel Disease (IBD)](https://www.ligastrohealth.com/ibd/) - [Irritable Bowel Syndrome (IBS)](https://www.ligastrohealth.com/what-is-ibs) - [Liver, Pancreas, & Gallbladder](https://www.ligastrohealth.com/liver-pancreas-and-gallbladder/) - [Celiac Disease & H.pylori](https://www.ligastrohealth.com/celiac-disease-and-h-pylori/) - [Gluten Sensitivity](https://www.ligastrohealth.com/gluten-sensitivity) ### PROCEDURES - [Capsule Endoscopy](https://www.ligastrohealth.com/capsule-endoscopy/) - [Colonoscopy](https://www.ligastrohealth.com/colonoscopy/) - [Upper Endoscopy](https://www.ligastrohealth.com/upper-endoscopy/) [Information for Patients](https://www.ligastrohealth.com/patient-resources/) [![Northwell Health Logo](https://www.ligastrohealth.com/hs-fs/hubfs/LICDH_NorthwellHealthLogo.png?width=120&height=65&name=LICDH_NorthwellHealthLogo.png)](https://www.northwell.edu/) [![ACG logo](https://www.ligastrohealth.com/hs-fs/hubfs/Licdh%20January2018%20Theme/Images/ACG-Logo2.jpg?width=121&height=121&name=ACG-Logo2.jpg)](http://gi.org/) [![AGA logo](https://www.ligastrohealth.com/hs-fs/hubfs/Licdh%20January2018%20Theme/Images/AGA-Logo.jpg?width=131&height=131&name=AGA-Logo.jpg)](https://www.gastro.org/) [![ASGA logo](https://www.ligastrohealth.com/hubfs/Licdh%20January2018%20Theme/Images/ASGA-Logo.jpg)](http://www.asge.org/)  [![APEX Awards logo](https://www.ligastrohealth.com/hs-fs/hubfs/Licdh%20January2018%20Theme/Images/LICDH_AwardLogo1.jpg?width=125&height=125&name=LICDH_AwardLogo1.jpg) ](http://www.sphanalytics.com/apex-awards/)[![U.S. News Best Ambulatory Surgery CentersHealthHome Best Ambulatory Surgery Centers](https://www.ligastrohealth.com/hs-fs/hubfs/image001.png?width=61&height=69&name=image001.png)](https://health.usnews.com/best-ascs)[![Physicians Endoscopy](https://www.ligastrohealth.com/hs-fs/hubfs/Licdh%20January2018%20Theme/Images/LICDH_FooterLogos_PhysiciansEndoscopy.jpg?width=231&height=82&name=LICDH_FooterLogos_PhysiciansEndoscopy.jpg)](http://www.endocenters.com/) Gastroenterology Associates (GA) specializes in the diagnosis and treatment of all types of gastrointestinal, liver, pancreatic and gallbladder diseases. Serving the North and South shores of Long Island, (including: Central Nassau County, Garden City, Mineola, Westbury, East Meadow, Hempstead, New Hyde Park, Hicksville, Levittown, Floral Park, Rockville Centre and Williston Park.) We have helped thousands of people by providing care for digestive diseases, colon cancer screening, IBS and IBD (ulcerative colitis, Crohn’s disease), GERD, heartburn and acid reflux, swallowing disorders, liver, pancreatic and gallbladder disease, ulcers, celiac disease and H. pylori. [Privacy Policy](https://www.ligastrohealth.com/privacy/) Copyright © 2026 Gastroenterology Associates, PC. 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