Forms, Consents and Documents
 
To facilitate your registration process, please print and fill out all necessary forms for your visit.  Any questions you may have on any of these forms will gladly be answered the morning of your visit or procedure.

Patient Registration:
For us to provide the best possible care for you, we will need to know about your personal and family medical history, your current symptoms, and the medications you are currently taking.
 
Patient Information Line:
The Center for GI Health is committed to providing you all information available in the easiest way possible.  This form describes the process for you to gather laboratory results, doctor's instructions, and any other pertinent information.
 
Financial Responsibility Forms:
This form is used if you are not covered by insurance or choose to have a procedure performed without a referral.
 
 
Notice of Privacy Practices:
Click the link below to download our notice of privacy practices.
 
HIPAA:
HIPAA (Health Insurance Portability and Accountability Act) allows you the right to restrict how your PHI (Personal Health Information) is used or disclosed. During registration, you will be asked questions regarding HIPAA. You will then be asked to sign an electronic signature pad which acknowledes your response to the questions.
 
 
Patient Financial Responsibility:
Click the link below to download our Patient Financial Responsibility form.
 

 
Informed Consent:
 
Prior to the start of your procedure you will be asked to read and
sign an Informed Consent form. This document explains the risks and benefits of your procedure as well as alternative procedures. By signing this document, you acknowledge your understanding of the risks, benefits, and alternatives as well as the fact that you were able to discuss this with your physician.
 
Colonoscopy

Endoscopy
HIPAA:
HIPAA (Health Insurance Portability and Accountability Act) allows you the right to restrict how your PHI (Personal Health Information) is used or disclosed. During registration, you will be asked questions regarding HIPAA. You will then be asked to sign an electronic signature pad which acknowledes your response to the questions.
 
Living Will/Advanced Directives/Medical Power of Attorney:
Living wills, advanced directives, and medical power of attorney are documents which direct what medical care/treatment you would recieve or the designation of a person to make the decisions for you if you became unable to do so yourself. As part of your admission interview, you will be asked if you have any of these documents. They are not required for you to undergo your procedure; however, The Endoscopy Center is required to ask if you have one or if you request information regarding the topic. Should you desire, information and sample forms are available to you at The Endoscopy Center.
Patient EMR Portal
The Center for GI Health will soon be debuting a CCHIT certified portal for all patients to access their electronic medical records. This will allow all patients the ease of entering all required information directly into our secure server and access their charts.

Learn More


Contact Information / Office Hours

Center for GI Health Sellersville (8:30-4:30 M thru F)
Phone: 215-257-5071
Fax: 215-257-1801
817 Lawn Avenue
Sellersville, PA 18960
Center for GI Health Lansdale
Phone: 215-257-5071
815 Sumneytown Pike
Suite 210
Lansdale, PA 19446
Center for GI Health Springhouse
Phone: 215-257-5071
909 Sumneytown Pike, Suite 106
Springhouse, PA 19477
The Endoscopy Center (7-3 M thru F)
Phone: 215-453-3050
817 Lawn Avenue
Sellersville, PA 18960
About Us

The Center for GI Health, formerly known as Upper Bucks Medical Associates, has been serving the community since 1973. Our practice has expanded over the years from one to four physicians. CGI is dedicated to provide the highest level of care combining experience and education with compassion and understanding. We have most recently added a female physician to our practice in 2006. This has added a level of comfort for those patients who seek a female to deliver their GI care. CGI has full staff privileges at Grand View Hospital located just across the street from our office and Endoscopy Center.
Hospital Affiliations

The Center for GI Health and The Endoscopy Center are affiliated with Grand View Hospital in Sellersville PA and Abington Hospital in Lansdale PA.


DISCLAIMER
This web site is intended for general educational and informational purposes only.
If you leave our site through one of the associated links, the information contained in those sites is under the authority of that site and has not
been screened for accuracy or content by The Center for GI Health or The Endoscopy Center.
The Center for GI Health and The Endoscopy Center assumes no responsibility in the use or interpretation of information through the associated links.
If you would like to contact us, please call 215-257-5071


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