[et_pb_section bb_built=”1″ gutter_width=”2″ next_background_color=”#88a2b6″ _builder_version=”4.14.7″ background_color=”#25438d” vertical_offset_tablet=”0″ horizontal_offset_tablet=”0″ hover_enabled=”0″ box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px” global_colors_info=”{}” global_module=”213430″][et_pb_row global_parent=”213430″ _builder_version=”4.17.4″ hover_enabled=”0″ global_colors_info=”{}”][et_pb_column type=”4_4″ global_parent=”213430″ _builder_version=”3.0.47″ custom_padding=”|||” hover_enabled=”0″ global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_image global_parent=”213430″ src=”http:\/\/ascbuffalo.com\/wp-content\/uploads\/2022\/10\/asclogo5.png” _builder_version=”4.14.7″ background_color=”#25438d” vertical_offset_tablet=”0″ horizontal_offset_tablet=”0″ hover_enabled=”0″ z_index_tablet=”0″ box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px” global_colors_info=”{}” \/][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section bb_built=”1″ gutter_width=”2″ fullwidth=”on” prev_background_color=”#25438d” next_background_color=”#ffffff” _builder_version=”4.14.7″ background_color=”#88a2b6″ vertical_offset_tablet=”0″ horizontal_offset_tablet=”0″ hover_enabled=”0″ box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px” global_colors_info=”{}” border_width_all=”1px” global_module=”213438″][et_pb_fullwidth_menu global_parent=”213438″ menu_id=”2″ menu_style=”centered” submenu_direction=”downwards” fullwidth_menu=”off” _builder_version=”4.17.4″ menu_font=”|600|||||||” menu_font_size=”16px” vertical_offset_tablet=”0″ horizontal_offset_tablet=”0″ hover_enabled=”0″ z_index_tablet=”0″ menu_text_shadow_horizontal_length=”menu_text_shadow_style,%91object Object%93″ menu_text_shadow_vertical_length=”menu_text_shadow_style,%91object Object%93″ menu_text_shadow_blur_strength=”menu_text_shadow_style,%91object Object%93″ menu_text_shadow_horizontal_length_tablet=”0px” menu_text_shadow_vertical_length_tablet=”0px” menu_text_shadow_blur_strength_tablet=”1px” box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px” box_shadow_horizontal_image_tablet=”0px” box_shadow_vertical_image_tablet=”0px” box_shadow_blur_image_tablet=”40px” box_shadow_spread_image_tablet=”0px” global_colors_info=”{}” \/][\/et_pb_section][et_pb_section bb_built=”1″ fullwidth=”off” specialty=”off” prev_background_color=”#88a2b6″ inner_width=”auto” inner_max_width=”1123px”][et_pb_row][et_pb_column type=”4_4″ custom_padding__hover=”|||” custom_padding=”|||”][et_pb_divider _builder_version=”4.14.7″ show_divider=”off” box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px” vertical_offset_tablet=”0″ horizontal_offset_tablet=”0″ z_index_tablet=”0″ \/][\/et_pb_column][\/et_pb_row][et_pb_row background_position=”top_left” background_repeat=”repeat” background_size=”initial” width=”80%” max_width=”1123px”][et_pb_column type=”4_4″ custom_padding__hover=”|||” custom_padding=”|||”][et_pb_text background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid” background_position=”top_left” background_repeat=”repeat” background_size=”initial”]<\/p>\n
\nPATIENT REGISTRATION<\/strong><\/span><\/p>\n Please click on one of the links below to download the forms you will need to complete and bring with you the day of your Surgery (B101) or GI procedure. (A102).<\/span><\/p>\n Patient Forms for both Surgical and GI Procedures:<\/span><\/strong><\/span><\/p>\n Authorization for Release of Health Information Pursuant to HIPAA<\/a><\/span><\/span><\/p>\n Consent For Care & Treatment & Payment Agreement<\/a><\/span><\/span><\/p>\n Additional GI Forms needed:<\/span><\/strong><\/span><\/p>\n GI Patient History<\/a><\/span><\/span><\/p>\n