Patient Forms
At Johnston Endoscopy Center, your time is as valuable to us as it is to you. That’s why we provide online access to a variety of forms. Please take a moment to download and complete the patient information sheet. All other forms are for you to read only.
The Patient Health History Sheet should be completed in its entirety and brought with you to our facility the day of your procedure.
Please contact your GI physician’s office for further evaluation if you are taking Ozempic, Semaglutide, Mounjaro, Tirzepatide, Wegovy, Victoza, Saxenda, Byetta, Trulicity, or Phentermine. You may have to hold dosages or reschedule your procedure.
Please note if you have a Difficult Airway Letter from previous surgeries or use Home Oxygen, you may need to be rescheduled to the hospital for your procedure. Please notify your physician’s office if either of these situations pertain to you. If you are a smoker or chew tobacco, please refrain from smoking/chewing on the day of your procedure. If you have a question about the preparation for your procedure, please call your physician’s office.