Skip to main content
Excellent Service, Compassionate Care
Patient Portal
HG Wellness Program
Behavioral Health
Open Navigation
Menu
About Us
Vision and Values Statement
Administrative Staff
Contact Us
Providers
Services
Procedures & Tests
Colonoscopy
Esophagogastroduodenoscopy (EGD)
Flexible Sigmoidoscopy
with Sedation
ColoCleanse
Other
BRAVO / 96 hour Esophageal pH Monitoring
Capsule Endoscopy
Endoscopic Mucosal Resection (EMR)
Endoscopic Ultrasonography (EUS)
Esophageal Manometry
Fecal Microbiota Transplant (FMT)
Fit3D Scan
Gastric Emptying Breath Test
Ileoscopy with no Sedation
Ileoscopy with Sedation
Liver Biopsy
Paracentesis
Percutaneous Endoscopic Gastrostomy (PEG)
Pneumatic Balloon Dilation
Pouchoscopy (with Sedation)
Pouchoscopy (with No Sedation)
Radiofrequency Ablation (RFA)
Retrograde Cholangiopancreatography (ERCP)
Ultrasound-based Liver Elastography
Research
Sponsor Information
Active Clinical Trials
Previous Clinical Trials
Locations
Ann Arbor/Ypsilanti: HG Center for Digestive Care
Ann Arbor/Ypsilanti: Imaging Center
Brighton: Woodland Center
Chelsea: Professional Building
Chelsea: Hospital Surgical Suite
Howell: Livingston Hospital
Livonia: HG Endoscopy Center
Livonia: Trinity Health Hospital
Career Opportunities
Search
Share
Print
Home
BH Consent and Assessment Forms
Request a Procedure Appointment
go
Patient Forms
go
Prep for your Procedure
go
Insurance Information
go
Pay Now
go
For Referring Physicians
Consent and Assessment Forms
Below are our GI Behavioral Health consent and assessment forms:
Biopsychosocial Assessment
Limits of Confidentiality
Teletherapy Consent
Close