If you have any questions regarding the Patient Forms feel free to contact our main office at 516-785-6800.
Patient Registration Form
Consent for Use and Disclosure of Protected Health Information
Patient Financial Responsibility Statement
Card on File Agreement
Notice of Privacy Practices
HIPAA Consent
Office Policies
Medical Procedure Billing Form
Medical Records Release Form
Your first visit to our office will be in the form of a consultation. The physician will meet with you to discuss your gastrointestinal issues, medical and social history, and to perform a physical examination. They will then discuss with you a treatment plan and course of action.
Capsule Endoscopy
Colonoscopy
Upper Endoscopy
Flexible Endoscopy
Other Tests
Our office participates in many insurance plans. If your insurance plan is not listed, please call your insurance company to confirm participation.
For additional information regarding out-of-network benefits, plan-specific information, or other billing and insurance inquiries, the following contact will gladly assist you.
The main number for billing inquiries for Allied Digestive Health is: (732) 702-1039
Additionally, we accept cash, credit, and checks for self-pay patients and all other payments.
For Your Visit
Wantagh North
P: 516-785-6800
F: 516-785-2121
1488 Wantagh Avenue
Wantagh, NY 11793
Mon – Thurs: 8:30AM – 5:00PM
Fri: 8:30AM- 4:30PM
Sat & Sun: Closed
Wantagh South
P: 516-785-6800
F: 516-785-2121
2155 Wantagh Avenue
Wantagh, NY 11793
Mon – Thurs: 8:30AM – 5:00PM
Fri: 8:30AM- 4:30PM
Sat & Sun: Closed
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