Patient Registration - Forms

Welcome to Gastroenterology Specialties

          and Lincoln  Endoscopy Center

For your first visit please complete all 4 forms. 

Our website provides the paperwork needed so that we may open a medical chart for you. Please print and fill out the following new patient forms prior to your appointment and bring them along with your insurance card, a referral (if required) from your primary care physician, and additional test results or pertinent medical records. We also suggest that you arrive 20 minutes early for your scheduled office appointment and 30 minutes early for your procedure at Lincoln Endoscopy Center.

For follow-up appointments you do not need to complete any additional forms.

For procedures or have not been seen in 3 years as an existing patient, please complete the history and physical form.  If the nurse has called you and taken the information, do not complete the form on line.

All of this will hopefully lead to a prompt and stress free first visit with us. We look forward to providing you and your family with the highest quality medical care in a professional setting. If you have additional questions call 402-465-4545.