Patient Self-Referral Form
Many insurance carriers have waived the need to have a physician referral prior to seeing a specialty provider. If you are in need of care from one of our gastroenterologists, and to see if your insurance qualifies, please fill out this brief form and one of our patient representatives will reach out to you shortly after receiving the form. Our team of dedicated care members work diligently to get your information processed quickly, often within 24-48 hours.
Physician Referal Form
Physician offices can now effortlessly send referrals directly to our Premier Gastroenterology providers by completing the brief form provided in the link below. After answering a few quick questions and attaching both the most recent patient medical record and demographic form, simply click "submit," and your referral will be sent directly to our patient referral coordinators. This method ensures HIPAA compliance while streamlining the referral process to promptly address your patient's needs.
Open Access Screening Colonoscopy Form
The Open Access Program allows healthy, age-appropriate patients (those with no significant gastrointestinal symptoms) to have a colonoscopy performed without having to schedule a preop office visit.