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Patient Forms

At Eastern Shore Endoscopy, your time is as valuable to us as it is to you. Upon scheduling your surgery, a member of our staff will provide you with the required forms. We encourage you to review these forms before arriving on the day of surgery, so that we may care for you promptly.

Anesthesia Consent Form

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Consent to Surgery/Procedure (English)

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Consent to Surgery/Procedure (Spanish)

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Patient’s Rights and Notification of Physician Ownership (English)

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Patient’s Rights and Notification of Physician Ownership (Spanish)

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Notice of Nondiscrimination

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Maryland Advance Directive: Planning for Future Healthcare Decisions

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Eastern Shore Endoscopy
511 Idlewild Avenue,
Easton, MD 21601

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