NARCISO L. GOMEZ, MD

General, Colorectal and Weight Loss Surgery

3475 Sheridan Street
Suite 201
Sheridan Exec. Centre
Hollywood, FL. 33021
(954) 369-5717

Patient Forms

You can now download all the necessary forms below:

You can now download all the necessary forms below:

HIPAA Acknowledgement
HIPAA Acknowledgement
HIPAA Consent
HIPAA Consent
Patient Consent Form
Patient Consent Form

Patient History
Patient History
Patient Information
Patient Information
Financial Policy
Financial Policy

Notice Privacy Practices
Notice Privacy Practices
Consent For Treatment
Consent For Treatment
Request Records
Request Records

Colorectal Cancer Screenings
Colorectal Cancer Screenings
The Surgical Process
The Surgical Process
Consent for Surgery or Procedures
Consent for Surgery or Procedures

Post Operative Care Instructions
Post Operative Care Instructions
Pre-Operative Care Instructions
Pre-Operative Care Instructions

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Call today for consultation
(954) 369-5717