Patient Registration Forms

Evergreen Endoscopy Center in South Windsor, Connecticut welcomes you to our center. If you are a new patient, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your appointment. Doing so will help speed up the new patient registration process.

Also, be sure to bring any diagnostic films or other test results that may have been ordered or performed by another physician.

Downloadable Forms:

• New Patient Registration
• Health History Questionnaire
• Confidential Channel Communication Request
• Summary of Privacy Practices
• Patient Consent Form
• Patient Bill of Rights
• Colonoscopy Preparation for SUPREP
• Colonoscopy Preparations For PREPOPIK

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.