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Medical Consents & Forms

    Capsule Consent

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    Consent for Endoscopy Procedure

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    Consent for Telemedicine

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    Endoscopy Center Financial Agreement

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    HIPPA – Notice of Privacy Practices

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    New Patient Forms

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    Procedure Financial Form

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    Release of Medical Records

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    Here For You

    North Coast Endoscopy advocates for our patients to live happy, healthy lives. This includes advocating for screening for colon cancer.

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    Main Office

    9500 Mentor Avenue, Suite 340
    Mentor, OH 44060

    T: 440-352-9400
    F: 440-352-9407

    Monday – Friday
    9:00 a.m. – 4:00 p.m.

    Find a location near you

    Endoscopy Center

    9614 Old Johnnycake Ridge Road,
    Mentor, OH 44060

    Monday – Friday
    8:30 a.m. – 4:00 p.m.