The following new patient and procedural preparation forms can be downloaded to your computer and printed at home for your convenience. By filling out these forms prior to your appointment you will save significant time during your visit at Dr. Matthew Eidem’s office. If you have any questions when filling out these forms, please do the best you can, and our staff will assist you with any questions on the day of your visit.
The procedural preparation forms will give you a detailed description of what you need to do during the 24-hour period before the procedure. Please use these as a guide, and contact Dr. Eidem’s office at (972) 867-0019 or firstname.lastname@example.org with any questions.
APPROVED INSURANCE PROVIDERS
NEW PATIENT FORMS & PORTAL INFORMATION
As a member of the Digestive Health Associates of Texas, Dr. Eidem’s billing is handled by the central billing office.
If you have a billing related question, please call 214-689-5960.
PROCEDURE PREPARATION FORMS
- Suprep Preparation for a Colonoscopy
- Suprep Split-Dose Preparation for a Colonoscopy
- Movi Split-Dose Preparation for a Colonoscopy
- Miralax Preparation for a Colonoscopy
- Preparation for an Endoscopy
Note: The above documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can click on this link to download it for free.