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GastroIntestinal Healthcare
Hours of Operation

Clinic Hours:
M/T/Thu (12:30pm-5pm),
Wed (7am-5pm)

Endoscopy Hours:

M/T/Thu (7am-12:45pm),
Fri (7am-2pm)

Phone & Fax

p 919.870.1311
f 919.881.0822

SE HABLA ESPAÑOL
Map & Directions

2011 Falls Valley Dr.
Suite 106
Raleigh NC 27615

Translate to Spanish:
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  • Our Practice
    • Our Facility
    • Patient Experiences
    • Referring Physicians
    • In the News
  • Meet the Doctor
  • Procedure Instructions
  • Patient Resources
    • Patient Forms
    • Prescription Refill Policy
    • Insurances Accepted
    • Procedure Billing Policy
    • Procedure Costs
    • Financial Policy
    • Self Pay
    • Financial Services
    • Missed Appointments
    • Collections
    • No Surprise Billing Act
    • Links & Education
  • Conditions
  • Procedures
    • Colonoscopy
    • Esophageal Dilation
    • Flexible Sigmoidoscopy
    • Upper Endoscopy
  • Blog
  • Contact

Home » Patient Resources » Patient Forms

Patient Forms

Please Read and Complete for Your Visit

For appointments, click here for a single PDF containing:

  • Financial Policy
  • HIPAA Form
  • Patient Registration Form (new patient)
  • Patient Registration Form
  • Patient Interview Form

Other Documents to bring if needed

  • Medical Records Release (release to 3rd party)
  • Patient Access Form (release to patient)

For Your Information – Please Read

  • HIPAA Privacy Notice
  • Notice of Nondiscrimination
  • Patient Rights Policy
  • Patient Responsibilities Policy
  • Telehealth Consent Form

 Spanish / Español

For appointments, click here for a single PDF containing:

  • Financial Policy
  • HIPAA Form
  •  Patient Registration Form (new patient)
  •  Patient Registration Form
  • Patient Interview Form
  •  Medical Records Release Form
  •  HIPAA Privacy Notice
  •  Patient Rights Policy
  •  Patient Responsibilities Policy

Monthly Healthy Living Newsletter

In the News Divider

#GivingTuesday GIH Donates $1,000 to the Raleigh Rescue Mission (8th Year In A Row!)

#GivingTuesday GIH Donates $1,000 to the Raleigh Rescue Mission (8th Year In A Row!)

In the spirit of supporting #GivingTuesday, GIH has made a donation of $1,000 to the Raleigh Rescue Mission. The Raleigh Rescue Mission transforms lives of homeless men, women and children by ministering to their physical, emotional and spiritual needs. This donation will be matched by an anonymous donor for a total gift of $2,000. #GivingTuesday is…

Read More
GASTROINTESTINAL HEALTHCARE AGAIN DESIGNATED A TIER ONE PRACTICE BY BCBS,  UNITED HEALTHCARE, AETNA and CIGNA

GASTROINTESTINAL HEALTHCARE AGAIN DESIGNATED A TIER ONE PRACTICE BY BCBS, UNITED HEALTHCARE, AETNA and CIGNA

We are happy to report that again we here at GastroIntestinal Healthcare have been designated a Tier 1 practice by: Blue Cross and Blue Shield of North Carolina (BCBSNC) United Healthcare Aetna Cigna Tier 1 doctors and hospitals provide members care and services needed for a lower cost. You receive the highest level of benefits…

Read More
Exciting Cost Savings Opportunities for NC State Health Plan Employees

Exciting Cost Savings Opportunities for NC State Health Plan Employees

North Carolina State Health Plan Network Update     Happy New Year!   The State Health Plan (Plan) appreciates your partnership in the Clear Pricing Project (CPP) and for being part of the NC State Health Plan Network. We have a few reminders for you about the exciting incentives offered to our members. These incentives…

Read More
See all News Articles

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Contact Us

2011 Falls Valley Dr., Suite 106
Raleigh, NC 27615
919.870.1311
SE HABLA ESPAÑOL

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