Peninsula Gastroenterology Medical Group, Gastroenterologists logo for print
Redwood City: 2900 Whipple Ave | Suite 245 |Redwood City, CA 94062 • Phone: 650-365-3700
Mountain View: 2500 Hospital Drive | Building 8, Suite B | Mountain View, CA 94040 • Phone: 650-964-3636

Peninsula Gastroenterology Medical Group, Gastroenterologists

650-365-3700Redwood City
650-964-3636Mountain View

Patient Forms

Please read directions carefully for each section under Patient Registration forms.  

 

PATIENT REGISTRATION SECTION   OTHER FORMS

Welcome New Patients and Existing Patients!  There are three (3) ways for you to complete our registration process: Online, Carry In, or In Office

NOTE FOR EXISTING PATIENTS: If it has been over 1 year since we have seen you, please update your Medical History and Current Medications list.

 

Online

STEP 1:   (Must be completed prior to your visit):

If you haven’t already done so by an invitation in your email, please register and complete this portal Health Questionnaire. Your PIN was sent to you via the email address you provided. Registering on this portal will allow you to update your medical information as well as communicate with the office and your provider. If you haven’t received a PIN, please contact our office so that we can supply you with one. Click on the following link to be guided to the registration process or to log in to update your information:

STEP 2:

Please complete & submit these forms at least 24 hours prior to your scheduled appointment time.  The first item will be submitted online. Please click on Patient Demographics and complete the document by clicking the submit button at the end.   Items 2 and 3 require signatures so please print those two documents out and bring with you to your appointment along with your insurance card and your photo ID.

 

1. Patient Demographics 

2. Financial Policy

3. HIPAA Acknowledgement

Carry In:

Please press on link below and print out entire Patient Registration Package.  Complete documents beforehand and bring in to your visit along with your insurance card and a photo ID
            Read only: HIPAA Document
 

In Office

If you cannot print your documents, please make sure to arrive at your scheduled appointment at least 20 minutes early to allow ample time for check-in and help keep the doctors’ schedules running on time. Make sure to bring your insurance card and a photo ID

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Patient Satisfaction Survey

Medical Records Release


 Office Procedure Forms


Procedure Preparation Packets 

Colonoscopy Preps

Preparación Colonoscopia

Anesthesia Preps

Other Preps

 

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