Patient Forms

At Affiliated Endoscopy Services of Clifton, your time is as valuable to us as it is to you. That’s why we provide online access to a variety of forms that patients may complete before their visit. The following documents will help us expedite the check-in process for your appointment. Please take a moment to download and print the appropriate form(s).

Authorization and Consent Form – English

Authorization and Consent Form – Spanish

Notice of Privacy Practices – English

Notice of Privacy Practices – Spanish

Patient Registration Form – English

Patient Registration Form – Spanish

Patient Information

Patient Rights Brochure – English

Patient Rights Brochure – Spanish

Patient Responsibilities – English

Patient Responsibilities – Spanish

Patient Instructions for Procedure – English

Patient Instructions for Procedure – Spanish