Resources for Patients

The following handouts are available to download and print. Additional handouts and patient guidelines for some of our most common procedures will be added soon, so please check back.

All resources are available in PDF format.
Download Adobe Reader.

 

Trinity Center Resources
Form for New Patients (Interactive)			Medical Records Authorization Form
Form for New Patients (Basic)			Prescription Refill Form
Medical Records Request Form			Medical Records Release Form
Gastroenterology Resources
Dr. Kummer's Patient Forms:			Dr. Rajapaksa's Patient Forms:
HalfLytely® Preparation for Colonoscopy			Colonoscopy Preparation Instructions
Preparation for Upper G.I. Endoscopy			2-day Colonoscopy Preparation Instructions
Preparation for Sigmoidoscopy			Colonoscopy: Day of Procedure
			Colonoscopy with MoviePrep Instructions
			Upper Endoscopy Instructions
Forms for Special Circumstances: Use only when directed by Dr. Kummer
PEG Preparation for Colonoscopy			Phosphosoda Preparation for Colonoscopy
Imaging Resources
CT Scan: Questionnaire
Internal Medicine
Dr. Carron's Patient Forms:
Medical History Form			Sending Protected Health Information
Immigration Registration Form			Immigration Agreement