Clinical Forms
In order to support your hemorrhoid banding practice, the following documents are provided for download. Those documents marked with a red "DOC" are available for download in Microsoft Word to facilitate the use of your own letterhead and customized content.
Patient Hand-outs
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Informed Consent (English) |
Post-Band Patient Instructions (English) |
Patient Education - Nitroglycerin Ointment |
Fiber Recommendations |
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Informed Consent (Spanish) |
Post-Band Patient Instructions (Spanish) |
Informed Consent (Chinese) |
Post-Band Patient Instructions (Chinese) |
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Clinical Staff Documents
Chart Note |
Super Bill |
Prescription Medication Sheet |
Clinical Pearls |
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FAQs |
Information for Cross Covering Physicians |
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