Patient Forms

Once you have scheduled your appointment, we will need certain information from you as a new patient at Gastroenterology Associates of S.W. Florida, P.A., including details about your current gastrointestinal problem, your medical history, and insurance information.

For your convenience, our forms are available below. Simply download, print, and complete the appropriate form(s) before your arrival. This will help to speed up our new patient registration process.

You are welcome to complete the forms when you arrive for your scheduled appointment—just come around 15 minutes early. Below you’ll also find information about our financial policy, privacy practices, insurance and payment info, as well as everything you need to know about colonoscopy.

New Patient Forms

Additional Forms

Your First Appointment

Please arrive 15-30 minutes early so that we can complete your initial paperwork. Also, please bring the following with you:

  • Your patient insurance card
  • Photo ID
  • A list of current prescriptions or over-the-counter medication, including dose and frequency
  • Information about your medical and surgical history
  • Recent test results, x-rays, or relevant records

Insurance and Payment Information

Gastroenterology Associates of S.W. Florida participates in Medicare and most major insurance plans. Our practice will file insurance claims on behalf of our patients; however, patients are responsible for deductibles, co-insurance, co-payments, and non-covered charges.

If you have questions regarding billing or which insurance plans we currently participate in, please contact us at 239-275-8882, ext. 506.


Our online patient portal is available to securely track many aspects of your healthcare and communicate with our office. Call now to register.

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Our Office

We offer three locations in the Southwest Florida area for your convenience. Our facilities offer state-of-the-art treatment and services for all patients.

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We have worked with patients in Southwest Florida for more than 25 years. Request an appointment by phone or use our online request form.

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