GAP | Patient Documents, Forms, and Procedure Preparation Instructions

Patient Documents, Forms, and Procedure Preparation Instructions

Click the “plus sign” to access the documents that apply to you.

Procedure Forms

>> click form name to download
Before Your ProcedurePre-Procedure Packet
Consent to Procedures

Spanish (En Español)Pre-Procedure Packet
Consent to Procedures
Procedure Preparation Instructions

GAP works with YourPatientAdvisor to offer you access to professionals that can answer questions about your procedure preparation. You may contact them 24 hours a day at (800) 349-0285.

Below you will find GAP's most commonly used instructions for procedure preparation. For your safety, please only use the instructions that your physician has recommended for you.
>> click form name to download
EndoscopyUpper Endoscopy (EGD) Instructions

ColonoscopyMiralax Standard InstructionsColyte/Golytely/Nulytely InstructionsColyte Extensive InstructionsPlenvu InstructionsPlenvu Extensive InstructionsSuprep InstructionsSuprep Extensive Instructions Flexible SigmoidoscopyUnsedated Standard Flex Sig InstructionsUnsedated Renal Flex Sig Instructions
Spanish (En Español)Spanish Upper Endoscopy (EGD) InstructionsSpanish Miralax Standard InstructionsSpanish Colyte/Golytely/Nulytely InstructionsSpanish Suprep InstructionsSpanish Unsedated Standard Flex Sig InstructionsSpanish Unsedated Renal Flex Sig Instructions
Office Forms
>> click form name to download
English
Appointment Consent during COVID-19 Pandemic
Financial Policy
Telemedicine Consent Form
Medical Records Release Form
Request for Form Completion

Spanish (En Español)
Spanish Appointment Consent during COVID-19 Pandemic
Spanish Financial Policy
Spanish Telemedicine Consent Form
Spanish Medical Records Release Form
Policies
>> click form name to download
Notice of Privacy Practices
Notice of Privacy Practices (Spanish - en Español)

Pathology Disclosure Notice
Pathology Disclosure Notice (Spanish - en Español)

Notice of Nondiscrimination (English/(Spanish - en Español)
Language Assistance Policy (top 15 languages)