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Patient Forms |
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Colon and Rectal has Partnered
with Phreesia for
filling out part of our forms online.
After your appointment is scheduled by our office, you will be
receiving a email or text from Phreesia 5 days prior to your
appointment to complete your intake paper work. For best
results please use a mobile device with a camera so you can
upload a picture of your drivers license and insurance card.
Our office will also be sending out a 3 page Medical
Questionnaire separately by email. If you did not get it, you
can use the link below to get the form.
Click on the
PDF Version below that can be downloaded to your computer and filled
out then printed.
You can also print the PDF version and fill it
out by hand.
To download the PDF version look for the
download button typically located at the upper right hand corner
of the screen depending on your browser. You will need the free
Adobe Reader to fill it out on your computer and print the
forms. To sign the form digatley you will need to have a digital
signature on your reader or you can sign by hand after you print
it.
After completing the form, you can:
Mail to:
Colon and Rectal Associates, LTD
1235 Old York
Road,
Suite G 20
Abington, PA 19001
Please include copy of your driver's license, insurance card and
COVID-19 vaccination card!
Fax to:
(215) 517-0821
Please include copy of your driver's
license, insurance card and COVID-19 vaccination card!
Drop them off at our
Office:
1235 Old York
Road, Suite G 20, Abington, PA 19001
Please bring your driver's
license, insurance card and COVID-19 vaccination card!
Please bring your driver's license, insurance card and
COVID-19 vaccination card to your apointment.
Call our office if you have any questions!
(215) 517-1250
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Copyright ⓒ 2024,
Colon And Rectal
Associates, Ltd., All Rights Reserved.
Web Site designed and
maintained by
Future Visions.
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