If you have any questions regarding the Patient Forms feel free to contact our main office at 732-370-2220.
Consent for Use and Disclosure of Protected Health Information (PHI)
Medical Records Release
Notice of Privacy Practices
Card on File Agreement
Medical Procedure Billing Form
Office Policies
Patient Financial Responsibility Statement
Patient Registration Form
Patient HIPAA Consent 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.
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
Allied Digestive Health has partnered with HealthMark Group to ensure the accurate and timely completion of medical record requests.
Once you enter your email, you will receive an email with HealthMark to log in (no username or password required!). Click on the “submit request” button and follow the prompts from there. You will receive an email as soon as your records are available for download.
Do I have to remember another username and password?
Nope! HealthMark’s Request Manager uses email verification and secure links to get you your records quickly, efficiently and securely – and without yet another username and password to remember!
How long does it take to process requests?
Most record requests are processed within 8 business hours. So, one or two business days after you submit your request, your records will be delivered electronically – right to your inbox.
Is there a cost associated with obtaining my medical records?
HealthMark Group fulfills all requests for personal copies at no charge. If paper copies are requested a fee to cover delivery costs will be charged and must be paid before the records will be shipped.
About
Our GI Care
For Your Visit
Englishtown Office
P: 732-370-2220
55 Willow Lane, Suite 201
Englishtown, NJ 07726
Mon – Thurs: 9:00AM – 5:00PM
Fri: 9:00AM- 3:00PM
Sat & Sun: Closed
Howell Office
P: 732-370-2220
59 Kent Road
Howell, NJ 07731
Mon: 9:00AM – 5:00PM
Tue: 9:00AM – 5:00PM
Wed: Closed
Thurs: 9:00AM – 5:00PM
Fri, Sat & Sun: Closed
*Office hours are subject to change based on availability
Old Bridge Office
P: 732-370-2220
100 Perrine Road
Old Bridge, NJ 08857
Mon: Closed
Tue: Closed
Wed: 9:00PM – 3:00PM
Thurs: Closed
Fri, Sat & Sun: Closed
*Office hours are subject to change based on availability
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