Referring Physician

Home

About EAGA

Wellbrook Endoscopy Center

Our Physicians

A. Steven McIntosh, MD, FACG

Karen L. Weiss-Schorr, MD

David N. Socoloff, DO

Procedure Preparation

Patient Resources

Office Visits

Patient Rights & Responsibilities

Financial Policies

Insurances Accepted

Procedure Preparation

Referring Physician

Locations

Schedule an Appointment

Patient Forms

Referring Physician

The Physicians and staff sincerely appreciate your referral to our practice. Please take a moment to answer the questions below so that we may be able to assist your patients with the best possible care. If you have any questions or require special attention or needs, please contact our office directly.

		* Required
	Patient Name *	A value is required.
	DOB *	A value is required.
	Patient's Phone Number *	A value is required.
	Fax
	Insurance Carrier
	Reason for Referral *	A value is required.
	Referring Physician *	A value is required.
	Referring Physician Email *	A value is required.Invalid format.
	Do you have a preference as to which physician the patient is scheduled with?
	Preferred Physician	A value is required.
	Comments
	Slide to right and hit submit button

About EAGA Associations/Affiliations

Physicians

Referring Physicians

News & Events

Our Services
Consultation
Endoscopy
IV Infusions
Capsule Endoscopy

Endoscopy Center

Patient Resources
Office Visits
Financial Policies
Patient Rights & Responsibilities

Insurances Accepted
Patient Education
Patient Portal

Privacy
Sitemap

Join us on facebook!

Referring Physician

Take our After Endoscopy Care Survey »

Take our After
Endoscopy Care
Survey »