(847) 457-0028
  • Make a Payment
  • Directions
Request an Appointment

North Shore Endoscopy CenterNorth Shore Endoscopy Center

  • For Patients
    • Keeping You Safe
    • Direct Access Colonoscopy
    • Your Appointment
    • Patient Forms
    • Prep Instructions
    • Insurance and Billing
    • Latest Technology
    • Identifying Different Colonoscopies
    • Request an Appointment
  • Physicians
  • Our Procedures
  • Conditions
  • About Us

Patient Forms

At North Shore Endoscopy Center, 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).

Patient Registration Form – ENGLISH

Download

Patient Registration Form – SPANISH

Download

Medication Reconciliation Form

Download

Discharge Instructions – English and Spanish

Download

Billing Information

Download

Patient Rights and Notification of Physician Ownership

Download
Keeping You Safe Direct Access Colonoscopy Your Appointment Patient Forms Prep Instructions Insurance and Billing Latest Technology Identifying Different Colonoscopies Request an Appointment
  • Contact Us
  • Notice of Nondiscrimination
  • Notice of Privacy Practices
  • Internet Privacy Policy
  • Terms of Service
  • Billing Disclosure

North Shore Endoscopy Center
101 North Waukegan Road suite 980, Lake Bluff,
IL 60044, USA

© 2026 North Shore Endoscopy Center