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Office Use only Doctor: LRC Chart #: Appointment Date: Little Rock Diagnostic Clinic Gastroenterology Patient Questionnaire This information will become part of the medical record and is subject to
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To fill out the gastroenterology form, follow these steps:
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Start by entering your personal information such as name, date of birth, and contact details.
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Remember to indicate any previous diagnostic tests or imaging scans you have undergone related to your gastrointestinal health.
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Digestive problems such as persistent stomach pain, bloating, or diarrhea.
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Screening and surveillance for colorectal cancer or other gastrointestinal malignancies.
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Inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis.
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If you are experiencing any of these symptoms or conditions, consulting a gastroenterologist can help diagnose and provide appropriate treatment.
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