The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.
- Electrophysiology Study / Cardiac Ablation
- Off-Label Use of Prescription Consent
- Release of Medical Records (Photographs, Films/Videos) Consent
- Refusal to Consent to Treatment, Medication or testing
- Loop Recorder Insertion/Removal Consent
- Authorization for Use or Disclosure of Health Information
Please printout and complete the appropriate forms:
If you are scheduling a consultation with Dr. Gidney to discuss the WATCHMAN device, please read the information and follow the instructions below.