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Online Forms and Policies

Online Forms and Policies FAQ:

New Patient Form: New Patient form for individuals to fill out who are new HIMG prior to the first appointment.

Notice of Privacy Practice: Coming Soon!!

Privacy Practive Acknowldgement: Coming Soon!!

Medical Records Release: Medical Records Release for patients to fill out and sign for release of their individual medical records for other physicians and personal use.

Protected Health Information Release to Family Members: Release for patients to sign for family members or designated individuals to receive Protected Health Information (PHI) on in person, on the phone or electronically.

Request for Confidential Communications : Request for patient to receive alternate forms of communication from HIMG for reasons of confidentiality.

Patient Satistaction Survey: Endoscopy: Patient satisfaction survey for completion after a procedure in our GI/Endoscopy Suite.  You will receive an an e-mail or phone call requesting the completion of this survey.  Coming Soon!!