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Please click on the link below and print the registration packet. 
Fill it out completely and bring it with you 30 minutes before your appointment.

REGISTRATION PACKET

PLEASE FILL OUT PAPERWORK AND BRING TO SCHEDULED APPOINTMENT. 
BRING INSURANCE CARDS & PHOTO ID TO BE COPIED FOR YOUR CHART.
BRING COPAY IF YOU HAVE ONE TO BE PAID AT TIME OF VISIT
(IT WILL BE FOR A SPECIALTY CLINIC).
IF YOU DO NOT HAVE YOUR COPAY, INSURANCE CARD, OR PHOTO ID AT THE TIME OF YOUR VISIT WE WILL HAVE TO RESCHEDULE YOUR APPOINTMENT.
IF YOU ARRIVE AFTER YOUR APPOINTED ARRIVAL TIME WE WILL HAVE TO RESCHEDULE YOUR APPOINTMENT.

Office Hours and Appointments

The office is open Monday through Friday from 8:00 a.m. to  4:30 p.m. Our physicians are available for emergencies 24 hours a day; 7 days a week.

Other Languages Spoken

  • Spanish
  • Interpretation services for other languages can be arranged.

What to Bring to your Appointment

For your visit, please bring your insurance card(s), photo ID and a list of your current medications. Due to new privacy laws (HIPAA) we will need the insurance policy holder's social security number in order to submit the claim.

If your insurance plan requires a written referral form please bring the form to your appointment and give it to our receptionist when you arrive. If you are unsure as to whether or not you need a referral form, please call the member services number on your insurance card.

Co-payments and balances are collected at the time of service. We accept cash, personal checks or VISA/Mastercard & AMEX.

No Show Policy

We require a minimum of 72 hours notice ofcancellation of any procedure, or a $100 charge will be assessed.

A $25.00 charge will be assessed for "no showing" or failing to give 24 hour notice of the need to cancel all routine appointments.  This charge is not billable to the patient's insurance company and will ultimately be the responsibility of the patient.  All no show charges will need to be paid before the next appointment with the physician.

Any established patient who fails to show for appointments on three (3) occasions will be discharged from the Clinic.

All patients arriving AFTER the appointed arrival time will be considered as a late arrival and will be required to reschedule their appoinment. 

 

New Patients

Please arrive about 30 minutes early for your first visit. It is necessary for you to complete both demographic and medical history forms prior to seeing your doctor. If you have lab work or recent x-rays relevant to your visit, please bring them as well.

At Digestive and Liver Disease Consultants, P.C. your time and convenience are important to us. Therefore we are happy to provide you with the simplicity of pre-registering online for an upcoming office visit.

By opening and printing the forms at the top of this page ahead of time you will save time upon your arrival to our office. Please bring the completed forms with you at the time of your appointment.

When you have Questions

We realize you may have questions in between scheduled visits. Our office staff will relay questions to our nurses and physicians, as needed, and get back with you promptly. During office hours, our registered nurses will forward information concerning medical emergencies to our physicians. After hours and on weekends, the "on-call" physician can be reached through the answering service.

Test Results

We will call you if your test results indicate something needs to be addressed immediately. If you have not heard from our office within three weeks, please call us directly to obtain your results.

Payment Information

Digestive and Liver Disease Consultants, P.C. participates in most major health plans including:

  • Medicare
  • Blue Cross/Blue Shield
  • United Healthcare
  • Coventry
  • John Deere
  • Many other miscellaneous plans

Our acceptance of a specific health plan is subject to change.

Cancellations
If you are unable to keep an appointment, please give us at least 24 hours notice for office visits and 72 hours notice for procedures.

Requirements for Refill of medications Please do not call the clinic for your refill:  We ask that you notify your pharmacy directly to ensure we have the most up-to-date medication information. Allow 48 hours:  Please allow 48 hours for your refill request to be reviewed and approved.  We are not open on weekends, so refills requested on Saturday and Sunday will not be received until Monday. A written prescription is a legal document and needs to be taken to your pharmacy.  Telephone or fax authorization will not be given for prescriptions that have been written.

Please coordinate your refill needs with your doctor’s appointment whenever possible.  There are more frequent visits required to be on certain medications.  Lab testing is also required for certain medications and your request will not be refilled unless we have the lab test results.

 Due to the fact that your health condition can change over time, we do not authorize refills if it has been more than one year since you have been seen by a doctor in our clinic. Med refills will only be addressed during office hours Thanks for assisting us by planning ahead for your medication needs.