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Portland Gastroenterology Center

Portland Gastroenterology Center

161 Marginal Way • Portland, Maine 04101 • 207-773-7964
  • Patient Portal
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  • Careers
  • About PGC
    • Physicians & Staff
    • Disorders Treated
    • Endoscopy Center
    • Recognized Leadership
    • Careers
    • Location and Hours
  • Colonoscopy
    • Colon Cancer Screening
    • What to Expect
    • Colonoscopy FAQ
  • Upper Endoscopy (EGD)
  • Prep Instructions
    • Colonoscopy Prep FAQ
    • Standard MiraLAX Prep
    • Extended MiraLAX prep
    • Standard GoLYTELY® Prep
    • Upper Endoscopy Prep
  • Patient Resources
    • Appointment Policy
    • Patient Forms
    • Billing & Payments
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    • Medication Refills
  • Contact
Patient Forms
Everything You Need - In One Place

At PGC, we believe in supporting not only your health but also the health of our environment. We try not to drown you in paper, so we’ve put all our forms here for you to download and print as needed.

Click on the name of a form to download:

  • Patient Information Packet
  • Patient Rights and Responsibilities
  • HIPAA Notice of Privacy Practices
  • Privacy Policy
  • Facts About Health Care Advance Directives
  • State of Maine Advance Directives
  • Patient Record Request
  • Patient to Allow Disclosure of PHI
  • Patient Communication Form
  • Patient Request for Amendment of PHI
  • Billing Payment Policy
  • Nondiscrimination Notice

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  • About PGC
  • Colonoscopy
  • Upper Endoscopy (EGD)
  • Prep Instructions
  • Patient Resources
  • Patient Portal
  • Make A Payment
  • Careers

Portland Gastroenterology Center • 161 Marginal Way • Portland, Maine 04101 • phone: 207-773-7964 • fax: 207-773-9073
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