Skip to content
Indiana Gastroenterology, Inc. Logo
  • Home
  • About Us
    • Dr. William J. Fecht Jr.
    • Dr. Paul K. Frederick
    • COVID-19 Information
    • Office Staff
    • Hours & Locations
    • Hospital Affiliations
  • Patient Information
    • Forms & Instructions
    • Policies
    • FAQ
    • Health Resources
    • Prescription Refill Request
    • Office Visit Request
  • Physician
    • Referrals
    • Contact Physician
  • Contact Us
  • Online Payments
  • Home
  • About Us
    • Dr. William J. Fecht Jr.
    • Dr. Paul K. Frederick
    • COVID-19 Information
    • Office Staff
    • Hours & Locations
    • Hospital Affiliations
  • Patient Information
    • Forms & Instructions
    • Policies
    • FAQ
    • Health Resources
    • Prescription Refill Request
    • Office Visit Request
  • Physician
    • Referrals
    • Contact Physician
  • Contact Us
  • Online Payments
  • Home
  • About Us
    • Dr. William J. Fecht Jr.
    • Dr. Paul K. Frederick
    • COVID-19 Information
    • Office Staff
    • Hours & Locations
    • Hospital Affiliations
  • Patient Information
    • Forms & Instructions
    • Policies
    • FAQ
    • Health Resources
    • Prescription Refill Request
    • Office Visit Request
  • Physician
    • Referrals
    • Contact Physician
  • Contact Us
  • Online Payments

Patient Forms

Patient FormsDevMaster2020-10-29T11:45:36-04:00

Office Consultation Documents

  • Primary (Indianapolis) Office Appointment Letter
  • Satellite (Noblesville) Office Appointment Letter
  • Patient Demographics
  • Health Questionnaire

Endoscopy Documents

  • Endoscopy Appointment Letter
  • Carmel Endoscopy Center
    • Cover Letter
    • Patient Disclosure Form
    • Medication List
  • Riverview Hospital
    • Medication List

Bowel Preparations for Colonoscopy / Flexible Sigmoidoscopy

  • Capsule Endoscopy
  • HalfLytely
  • Miralax / Gatorade
  • NuLytely / GoLytely
  • Two Day Preparation
  • Suprep
  • Suprep / Clear Liquids
  • Plenvu
  • Plenvu / Clear Liquids
  • Flexible Sigmoidoscopy

Indianapolis (primary) office

9002 N Meridian St, Suite 200
Indianapolis, IN 46260
Phone: (317) 872-1161
Fax: (317) 819-5126

Noblesville (satellite) office

325 Westfield Road, Suite D
Noblesville, IN 46060
Phone: (317) 872-1161
Fax: 317-819-5126

Make Online Payment

$  

© 2020 Indiana Gastroenterology, Inc. All Rights Reserved.
X

Your physicians and staff at Indiana Gastroenterology are closely following the COVID-19 outbreak as are your primary care providers and referring physicians. Click here to read our full COVID-19 response information.

Read Full COVID-19 Information
Go to Top