If you have any questions regarding the Patient Forms feel free to contact our main office at 516-487-7677.
Patient
Registration Form
Consent
for Use and Disclosure of Protected Health Information
Patient
Financial Responsibility Statement
Card on File
Agreement
Notice of
Privacy Practices
HIPAA Consent
Office Policies
Medical Procedure
Billing Form
Medical
Records Release Form
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment. Educate yourself on your symptoms by reviewing the content on this website. Also, take some time to review our staff page and familiarize yourself with the doctors. A list of the laboratories, anesthesia services, and hospital affiliations can be found on our website and additional information is available upon request. We look forward to your first visit.
Allied Digestive Health has partnered with HealthMark Group to ensure the accurate and timely completion of medical record requests.
Once you enter your email, you will receive an email with HealthMark to log in (no username or password required!). Click on the “submit request” button and follow the prompts from there. You will receive an email as soon as your records are available for download.
Do I have to remember another username and password?
Nope! HealthMark’s Request Manager uses email verification and secure links to get you your records quickly, efficiently and securely – and without yet another username and password to remember!
How long does it take to process requests?
Most record requests are processed within 8 business hours. So, one or two business days after you submit your request, your records will be delivered electronically – right to your inbox.
Is there a cost associated with obtaining my medical records?
HealthMark Group fulfills all requests for personal copies at no charge. If paper copies are requested a fee to cover delivery costs will be charged and must be paid before the records will be shipped.
Thank you for your interest in setting up an appointment with us! To schedule your visit, please give us a call. We look forward to assisting you!
