Patient Forms, Map and Directions to Flagstaff Office

Are you planning your first visit to Northern Arizona Gastroenterology?  On this page you'll find the information you need to get started, including a map and directions to our Flagstaff office.  To save you time we've included our new patient forms, which you can print out and complete prior to visiting our office.

Mission Statement

Our practice is working together to realize a shared vision of uncompromising excellence in gastroenterology.

To fulfill this mission, we are committed to:

• Listening to those we are privileged to serve;
• Working to earn the trust and respect of our patients, our community and our profession;
• Exceeding our patients' expectations;
• Ensuring a creative, challenging and compassionate professional environment; and,
• Continuously striving for improvement at all levels.

Patient Forms

For your convenience, our patient forms are located below. Please download, print and complete the following forms so we can expedite your first visit:

• Patient Information Forms
• Demographic Form
• Patient Financial Policy
• HIPAA Consent Form

Our Notice of Privacy Practices link is below.  It is not necessary to print out this document, but it is available for your review.

• Noticy of Privacy Practices

If you are in need of your medical records from Northern Arizona Gastroenterology, we will require a signed Records Release Authorization.  Please download/print and complete the following form.  You can mail or fax (928-773-2548) it to our office.  We will release your medical records within three (3) business days of receiving your signed Authorization.

• Records Release Authorization

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

Insurance and Billing

Prior to your appointment, please contact our office to verify acceptance of your insurance plan.  Qualifications for insurance coverage may differ due to the uniqueness of each procedure and differences between insurance plans.  We are happy to file your claim with your insurance company for reimbursement.

Payment options include cash, personal check or money order, Visa, Mastercard, and Discover. Please contact our Financial Coordinator for details regarding payment plan options, 928-773-2547.

What To Expect

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. We look forward to your first visit.

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