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
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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