If you have any questions regarding the Patient Forms feel free to contact our main office at 845-362-3200.
Patient Registration Form
Alcohol and Social History
Consent for Use and Disclosure of Protected Health Information
Card on File Agreement
Notice of Privacy Practices
HIPAA Consent
Office Policies
Medical History Form
Medical Procedure Billing Form
Medical Records Release Form
Your first visit to our office will be in the form of a consultation. The physician will meet with you to discuss your gastrointestinal issues, medical and social history, and to perform a physical examination. They will then discuss with you a treatment plan and course of action.
You may have been given specific instructions along with one of the following preparations after meeting with the physician. If you have misplaced this information, please contact the office directly. The start times of each of the preparations are dependent on the time of your scheduled procedure so please call the office for any questions regarding when to start your preparation.
Colonoscopy Preparations
Please contact our office to verify the acceptance of your insurance plan. Qualifications for insurance coverage may differ due to the uniqueness of each procedure and insurance plan. We are happy to file insurance for your reimbursement as long as you are free to choose your own gastroenterologist. For out-of-network services, the estimated amount a patient will be billed is available upon request.
The main number for billing inquiries for Allied Digestive Health is: (732) 702-1039
Allied Digestive Health has partnered with HealthMark Group to ensure the accurate and timely completion of medical record requests.
Once you enter your email, you will receive an email with HealthMark to log in (no username or password required!). Click on the “submit request” button and follow the prompts from there. You will receive an email as soon as your records are available for download.
Do I have to remember another username and password?
Nope! HealthMark’s Request Manager uses email verification and secure links to get you your records quickly, efficiently and securely – and without yet another username and password to remember!
How long does it take to process requests?
Most record requests are processed within 8 business hours. So, one or two business days after you submit your request, your records will be delivered electronically – right to your inbox.
Is there a cost associated with obtaining my medical records?
HealthMark Group fulfills all requests for personal copies at no charge. If paper copies are requested a fee to cover delivery costs will be charged and must be paid before the records will be shipped.
About
Our GI Care
For Your Visit
New City
P: 845-362-3200
500 New Hempstead Road, Suite A
New City, NY 10956
Mon – Thurs: 9:00 AM – 5:00 PM
Fri: 9:00 AM – 4:00 PM
Sat & Sun: Closed
Howell Office
P: 732-370-2220
59 Kent Road
Howell, NJ 07731
Mon: 9:00AM – 5:00PM
Tue: 9:00AM – 6:00PM
Wed: Closed
Thurs: 9:00AM – 6:00PM
Fri, Sat & Sun: Closed
Old Bridge Office
P: 732-370-2220
100 Perrine Road
Old Bridge, NJ 08857
Mon: Closed
Tue: Closed
Wed: 12:00PM – 8:00PM
Thurs: Closed
Fri, Sat & Sun: Closed
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