Houston Gastroenterology Patient Forms

Bay Area Gastroenterology offers two convenient methods of completing the forms necessary for proper handling of patient records:

You can use our secure medical record portal/gPortal. If you have not registered for the gPortal, please contact our office to receive an invite to your email with a 6 digit pin number to register.

or

You may download the forms in PDF format. If needed, download the free Adobe Acrobat Reader from Adobe to view and print the PDF versions of the form. Depending on the version of your web browser, the PDF files may open in your browser window. If this is the case, simply print the forms from your web browser. Fill them out and remember to bring them with you on your visit.
Online Version
Clinical Evaluation – New Patient Interview Form

 
PDF Version
Clinical Evaluation Form (New Patient Interview Form)

Patient Registration Form (Patient Demographics)

 

 
Patient Consent of Release of Information
HIPAA Form (Consent for Release of Information)

ERX Consent Form (ePrescribing Consent Form)

Receipt of Notice of Privacy Practices Form