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North Shore Gastroenterology & Endoscopy Centers
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    • Useful Links
  • Community Involvement
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    • Brooklyn, Ohio
    • Westlake, Ohio

Patient Forms

To help make your first visit as efficient and stress-free as possible, North Shore Gastroenterology provides convenient access to all required patient forms online. New and existing patients at our Westlake and Brooklyn, OH, offices can download, complete, and bring these forms to their appointment to streamline check-in and reduce time spent in the waiting room. Preparing these documents in advance also ensures our care team has the medical history and information needed to support your gastrointestinal care from the moment you arrive.

New Patient Forms

All new patients are required to complete the first three forms listed below. These files are available as PDFs and can be downloaded and printed at home. Please bring the completed forms with you to your first appointment, along with any recent imaging, diagnostic test results, or records from other providers.

  • Office Policy (complete prior to arrival)
  • Registration Form (complete prior to arrival)
  • Patient History Form (complete prior to arrival)

Additional Forms

Depending on your visit, procedure, or insurance requirements, your provider may also ask you to complete one of the following forms:

  • Endoscopy Consent Form
  • Authorization To Disclose Health Information to Another Provider
  • Authorization To Disclose Health Information Sent to North Shore Gastroenterology
  • Advance Beneficiary Notice Form (Medicare patients only)

Returning or Established Patients

Established patients may update medical information or required forms directly through our secure patient portal. If you have questions about the portal or need assistance logging in, please call our office and a staff member will be happy to help.

Please note: depending on your internet connection, forms may take a few moments to load. If you are unable to view a form, you may need to install Adobe Acrobat Reader.

 Patient Forms at North Shore Gastroenterology

If you need assistance with patient forms or preparing for your upcoming visit, contact North Shore Gastroenterology at (440) 808-1212 or request an appointment to speak with our team at either our Westlake or Brooklyn location.

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Blog

Discover the latest information on medical breakthroughs in the field of gastroenterology, as well as updates related to our practice at North Shore Gastroenterology’s exclusive online blog.

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Westlake Office and Endoscopy Center

850 Columbia Road, Suite 200
Westlake, OH 44145
Phone: (440) 808-1212
Fax: (440) 808-0321

Brooklyn (Ridge Park) Office and Endoscopy Center

7580 Northcliff Avenue, Suite 1000
Brooklyn, OH 44144
Phone: (440) 808-1212
Fax: (216) 663-8286

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