Patient Forms

If you are a free case review, have a new patient appointment in our offices, or have been scheduled for a new patient telehealth, please >access the required forms and policies here< (“forms #1”).You will need to print and complete this file and return it to the Center with your related materials and/or in advance of your appointment.

Other forms & information:

If you are a CEC patient who has undergone surgery with us, please complete our 'CEC team evaluation' feedback form by clicking here. Many thanks for sharing your initial impressions and evaluation!

If you are a post-operative CEC surgical patient who is at least 6 months out from your surgery date (preferably 12+ months), please click here to provide your post-surgical follow-up information. Thank you to the countless CEC patients who generously provide their feedback and help us maintain our follow-up data.

If you are seeking another copy of our bowel prep instruction sheet (provided at preop), click here.

Click here if you need a records release form from the CEC to provide records to yourself or another physician. Note that you can also access and share your records anytime from your secure portal.

Click here if you need a records release form to the CEC for your physician to release records to you for the purposes of your surgical consult with us.