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Patient Forms

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The best way to submit new patient forms is through our patient portal

Patient Login

If you are a new patient, contact our office to request an email invitation to register for the patient portal. All forms are available through the portal.

For your convenience, we provide the forms in Google Docs format so that you can open and print from your browser.

1. Patient Demographic Form

2. Medical History Form

3. Authorization Release Form (if you would like us to request your records)

Notice of Privacy Practices

Review our privacy policy (short and long form available)

4. Receipt of Notice of Privacy Practices

Bob Corso of WHSV TV3 Interviews Dr. Pou about colonscopy advice

A change to address the unknown — 6 GIs react to U.S. Preventive Services Task Force's recommendation to lower CRC screening age to 45

The U.S. Preventive Services Task Force proposed lowering the colorectal cancer screening age to 45 in response to growing early-onset CRC rates. In the news article linked below, six gastroenterologists discuss how the change will affect their practice.

Shenandoah Valley Gastroenterology was the first GI practice to validate the changes in screening colonoscopy to age 45 as seen in an interview of Dr. Pou on WHSV.

Watch Dr. Pou Interview on WHSV Reaction from 6 Gastroenterology Practices

Make an Appointment for a Screening

Do you know how to reduce your risk of colorectal cancer? The risk of getting colorectal cancer increases with age. Colorectal cancer screening saves lives, but many people are not being screened. The first step is yours … contact our office to make an appointment.

Make an appointment