• Skip to main content
  • Skip to footer
  • SOUTH LEESBURG: (352) 404-4334
  • LADY LAKE/THE VILLAGES: (352) 753-1612
  • LEESBURG: (352) 323-8868
Advanced Gastroenterology & Surgery Associates
  • Transparency
  • Online Bill Pay
  • Patient Login
  • Request an Appointment
  • Home
  • Our Physicians
    • Lily Tran MD
    • Garth O. George MD FACG
    • MaoHao Charlie Han MD
    • Tri H. Huynh, DO, FACG, FASGE
    • Leslie Mead APRN
  • Specialties
    • Gastroenterology
    • Gastroenterology Diagnosis & Treatment
    • Gastroenterology Procedures
    • General Surgery
    • Proctology
    • Thoracic Surgery
  • Patient Forms
  • Locations
    • Leesburg
    • Lady Lake/The Villages
    • South Leesburg
    • Ambulatory Surgical Centers
  • Contact Us

Patient Forms

Thank you for selecting Advanced Gastroenterology & Surgical Associates in Lake County, Florida for your medical care. To schedule an appointment, call the location nearest you or use our online appointment request form.

Once you have made your initial appointment, you may pre-register online by completing the interactive forms below, or you may download and print the forms, fill them out, and bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

Be sure to bring your insurance card, license or photo ID, plus any diagnostic imaging reports and blood lab work results from the last 6 months, or other test results that may have been ordered or performed by another physician.

If you are a new patient or an established patient who has not had an appointment with your doctor for one year, please complete new patient forms now, which will save you time in the office and provide more comprehensive information for your physician.

Downloadable Forms:

  • New Patient Packet Form
  • Billing, Insurance & HIPAA
  • Medical Record Request

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
Get Adobe Reader

Advanced Gastroenterology & Surgery Associates - Gastroenterology - Gastroenterologist near me - Gastroenterologist Leesburg fl - Gastroenterologist Lady Lake Fl - Gastroenterologist Clermont Fl

Footer

Patient Portal

Use our patient portal to access your lab results, request medical records and prescription refills, pay your bill online, and more.

REGISTER OR LOG IN NOW

Enter to Win

Complete our satisfaction survey, and you’ll be automatically entered to win our monthly drawing.

TAKE OUR SURVEY

PATIENT EDUCATION LIBRARY

The more informed you are about your digestive system, the better you can maintain your gastrointestinal health. Visit our patient education library for reliable and detailed information on gastroenterology and general surgery topics.

LEARN MORE

Alani Medical Spa

Relax and rejuvenate at Alani Medical Spa.Offering medical and cosmetic spa treatments.

Learn More

Alanis Medical Spa
  • Home
  • Our Physicians
  • Specialties
  • Patient Forms
  • Locations
  • Contact Us
  • Accessibility Statement
  • HIPAA Privacy Policy
  • Sitemap
  • SOUTH LEESBURG: (352) 404-4334
  • LADY LAKE/THE VILLAGES: (352) 753-1612
  • LEESBURG: (352) 323-8868

Copyright © Advanced Gastroenterology & Surgery Associates. All rights reserved.

iHealthspot Medical Website Design and Medical Marketing by iHealthSpot.com

The board-certified gastroenterologists at Advanced Gastroenterology & Surgery Associates, specialize in Gastroenterology, Gastroenterology Diagnosis & Treatment, Gastroenterology Procedures, Proctology, General Surgery, and Thoracic Surgery.