Endoscopy Surgery Form

If you're planning to have an outpatient endoscopy procedure at Sharp Memorial Outpatient Pavilion, you will need to fill out a Patient Database Form and bring it with you on the day of your surgery. This will help the hospital staff take better care of you, since we do not have access to your medical records from your doctor's office.

If you do not have a form from your doctor, you can download the form here, type in your information, print it out and and sign and date it.

You must have Adobe Acrobat Reader to open this document. Please note that Sharp HealthCare does not control or endorse the information presented on external websites, nor do these websites endorse the information found on www.sharp.com.

For More Information
If you have any questions about the form or endoscopy surgery, please call our patient registration assistant at 858-939-5095.

To find a Sharp-affiliated physician, call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm, or search for San Diego doctors. To learn more about Sharp's endoscopy services, go to Endoscopy in Sharp Services. For general health information about endoscopy, go to Digestive Disorders in Adult Health.