Patient Forms, Map and Directions to Burleson Office
Planning your first visit to Southwest Endoscopy and Surgery Center. On this page, you'll find the information you need to get started, such as a map and directions to our
Mission Statement
Our practice is working together to realize a shared vision of uncompromising excellence in gastroenterology.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Online Patient Forms
For your convenience, our online patient forms are located below:
- Notice of Privacy Practices and Authorization Form
- Notice To Patients
- Patients Rights
- Payment Guidelines
- Responsible Driver Agreement
Patient Forms
In addition, you may download, print and complete the following forms to bring to your first visit:
- Notice of Privacy Authorization Form
- Notice of Privacy Practices
- Notice To Patients
- Patients Rights
- Payment Guidelines
- Responsible Driver Agreement
In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download it.
Insurance and Billing
Please contact our office to verify acceptance of your insurance plan. Qualifications for insurance coverage may differ due to the uniqueness of each procedure. We are happy to file insurance for your reimbursement as long as you are free to choose your own gastroenterologist.
Payment Options
Please see our Financial Coordinator for details.
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.