Patient Registration

We welcome you to the Digestive Health & Nutrition Center! The first step in the process is to fill out the following forms for registration and your medical history. We aim to streamline your registration at the time of your appointment and provide Dr. Merlo with the necessary information prior to your consultation.

You and your information are important to Dr. Angela Merlo. Dr. Merlo has taken every precaution to protect the privacy of your personal and medical information. The information you submit will be electronically transferred using a HIPAA compliant provider that hosts web and email to allow for the safe and secure transfer of all your confidential information. This electronic host provider secures both the sending and receiving of electronic Protected Health Information (ePHI) for Dr. Merlo. You will have the opportunity to review and then sign your forms during your appointment at the Digestive Health & Nutrition Center. Contact us if you have questions. Remember to bring your insurance identification card to the appointment!

• Registration Form
• Medical History