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Colon Cancer Screening |
Angie Tierney will be happy to help you register for Open Access Colonoscopy or to answer any questions you may have. Please call her at (502) 893-0220 or you can send her an E-mail at atierney@gastroeast.com
You will need to print and fill out the following forms in order to register:
Patient Registration Form
Procedure Scheduling Form
Medical History Form
To open and read these forms, you will need a special FREE program. The one most commonly used on the Internet is Adobe Acrobat reader. If the above forms won't open after you download and click on them, then click on the button below, and download the correct version of the reader for your computer.
Michael V. Greenwell, M.D. • Laszlo J.K. Makk, M.D.
Kevin J. Heine, M.D. • Brian M. Dobozi, M.D.
Gastroenterology • Hepatology • Gastrointestinal Endoscopy
Dear Patient:
Your physician has requested that a physician in our gastroenterology group perform an outpatient screening colonoscopy at a time that is most convenient for you. The American Cancer Society and the American Gastroenterological Association both recommend that everyone 50 years of age and older undergo screening colonoscopy every ten years. Screening colonoscopy is performed to locate and remove precancerous polyps. Patients who have had precancerous polyps in the past may need to undergo colonoscopy more frequently than every ten years.
We will perform this colonoscopy as safely, conveniently, and comfortably as possible. To begin this process, please note the following forms that are designed to be downloaded from the internet and printed from your home computer (these forms can be opened and read using Acrobat reader and are located just to the right of this text).
Please fill out these forms and return them, along with a copy of both sides of your medical insurance card, to GastroEast Physicians.
The forms are: 1) Open Access Colonoscopy Patient Registration form, 2) Procedure Scheduling form and 3) Past Medical history information form.
These forms can be mailed to Angela Tierney R.N. or Open Access Colonoscopy Nurse at Gastroeast Physicians 3950 Kresge Way, Louisville KY, 40205 or faxed to Gastroeast Physicians at (502) 893-0563, ATTN: Open Access Colonoscopy or Angela Tierney.
While Medicare and most private insurers do pay for screening colonoscopy, we encourage you to contact your insurance carrier to ensure that screening colonoscopy is covered under your insurance plan.
After a physician from our office reviews your medical history, it may be determined that you should be seen for an office consultation prior to scheduling your procedure. This may be due to a current health issue or complaint, a serious past medical issue or a certain medication you are taking. We will make every effort to schedule this office visit at your convenience.
The procedure scheduling form allows you to select a day of the week and a hospital that is convenient for you to undergo colonoscopy. For your comfort, you will receive sedation during your colonoscopy. Therefore, you will need a family member or friend to drive you home after this procedure.
After all the forms are reviewed, you will receive a phone call from our staff to schedule your colonoscopy or if needed, an office consultation. We will make every effort to ensure your visit is as pleasant as possible. If you have any questions or concerns about this process, please do not hesitate to call our office at (502) 893-0220. Thank you for allowing us to participate in your health care.
Sincerely,
Michael V. Greenwell, M.D.
Laszlo J. K. Makk, M.D.
Kevin J. Heine, M.D.
Brian M. Dobozi, M.D.
3950 Kresge Way • Suite 207 • Louisville, KY 40207
www.GastroEast.com • (502 893-0220 • FAX (502) 893-0563