PATIENT FORMS

If this is your first time visiting our office, or if you have not been seen by Dr. Sampat for more than 2 years, please complete the necessary patient information forms listed below.  The endoscopy instruction forms below can be downloaded and printed for your convenience.

APPOINTMENTS

For an appointment please call 718-227-1282

Staten Island Office

Hours:

Monday: 8:30 AM – 8:00PM

Tuesday: 8:30AM – 4:30PM

Wednesday: 8:30AM – 4:30PM

Thursday: 8:30AM – 4:30PM

Friday: 8:30AM – 4:30PM

Telephone: (718) 227-1282

Fax:  (718) 967-2524

New Jersey Digestive Health (Aberdeen)

Hours:

Wednesday: 9:00AM – 12:00PM (Office visits)

Thursday: 9:00AM – 12:00PM (Procedures)

If you are unable to keep your scheduled appointment, please contact us at least 24 hours’ in advance.

INSURANCE ACCEPTED

Dr. Sampat participates in most insurance plans.

BILLING AND INSURANCE

Co-payments are due at the time of your visit in either cash or check. Verification of your current address and insurance information will be made at the time of each visit.

If the insurance plan you are enrolled with requires a referral, you must obtain one from your primary care physician prior to the scheduled visit. If you are insured by Medicare, then you will be required to pay the annual deductible and/or the balance of Medicare’s allowed charges, either personally or through a secondary insurance.

DIETS

The low FODMAP diet

IBS Diet

Gluten Free Diet

Reflux Disease Diet

Diverticulitis Diet