Peninsula Gastroenterology Medical Group, Gastroenterologists logo for print
Peninsula Gastroenterology Medical Group, Gastroenterologists
Redwood City: 2900 Whipple Ave | Suite 245 |Redwood City, CA 94062 • Phone: 650-365-3700
Mountain View: 2495 Hospital Drive | Suite 600 | Mountain View, CA 94040 • Phone: 650-964-3636

Due to COVID-19 concerns, PGI is providing telemedicine services.
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Appointment Form

You may use the form below to send a secure, online appointment request to our practice.  Our appointment request form allows you to request a specific provider, specific location and a general time and day of the week that best fits your schedule.  We will do our best to match your request with an available time slot in our practice management schedule.  Once we have identified an opening, we will contact you to confirm your appointment.

Note: Existing patients registered with MyChart may request and book appointments with our practice directly through the patient portal.

Patient Information
Patient Name:
Patient Date of Birth:
New or Existing Patient? New Patient
Existing Patient
Insurance:
Patient Address
Street Address:
City:
State:
Zip Code:
Contact Information
Home Phone:
Cell Phone:
Preferred Contact Method: Home Phone
Cell Phone
Email Address:
Appointment Information
Preferred Provider:
Preferred Location:
Preferred Day: Monday
Tuesday
Wednesday
Thursday
Friday
Preferred Time: Morning (AM)
Afternoon (PM)
Secondary Preferred Day: Monday
Tuesday
Wednesday
Thursday
Friday
Secondary Preferred Time: Morning (AM)
Afternoon (PM)
Question/Comment:

Related Links

Atherton Endoscopy Center photo

Atherton Endoscopy Center


Map & Directions

While you are a patient at Atherton Endoscopy Center, our highly competent and professional staff will care for you. Everyone from the receptionist to the physician embraces our philosophy of patient-focused care. Above all, our staff is friendly and concerned for your comfort.