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
Consent_for_Pelvic_and_Rectal_Exam
Consent for Pelvic and Rectal Exam

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

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Call today for consultation
(954) 369-5717