Patient Forms

Our physicians have been in practice in the Raleigh area for 30 years. Our physicians are board certified in GI/Internal Medicine, and have advanced endoscopic training. Our practice offers medical care for your Gastroenterology and Hepatology problems, as well as endoscopy services.

Our physicians are on staff at Rex Healthcare and Raleigh Endoscopy Center (an ambulatory surgery center for GI endoscopy).

If you have been referred to our office by another physician, we must have your records prior to your appointment.

Patient Forms – PDF
Patient Forms – Secure Electronic Submission

Medical Release

If you would like a copy of your records sent to another provider, or if you would like us to obtain your records from another provider, you must sign a release.

Medical Release Authorization