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The Forms and Information You Need

Our physicians have been in practice in the Raleigh area for 30 years. Our physicians are board certified in GI/Internal Medicine, and have advanced endoscopic training. Our practice offers medical care for your Gastroenterology and Hepatology problems, as well as endoscopy services.

Our physicians are on staff at UNC REX Healthcare and Raleigh Endoscopy Center (an ambulatory surgery center for GI endoscopy).

If you have been referred to our office by another physician, we must have your records prior to your appointment.

New Patient Online Form

(secure electronic submission)

Procedure Online Forms

(secure electronic submission)

Patient Forms – PDF

General Consent - English

General Consent - Spanish

Procedure Preparations

There are special preparations for each of the GI procedures we perform. Find more information about preparations specific to your procedure.

Medical Release

If you would like a copy of your records sent to another provider, or if you would like us to obtain your records from another provider, you must sign a release.

Medical Release Authorization [secure electronic submission]

Medical Release Authorization [PDF]

Contact Us

For appointments or more information, call (919) 791-2040 or fill out the form below.

Contact Us Form

Schedule a Colon Cancer Screening

Colon cancer screening is an important part of routine health care.

Schedule A Colon Cancer Screening