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Patient Forms

At Main Line Endoscopy Centers, your time is as valuable to us as it is to you. Upon scheduling your surgery, a member of our staff will provide you with the required forms to fill out. We encourage you to take time to complete these before arriving on day of surgery, so that we may care for you promptly.

What do I need to bring the day of my procedure?

  • Any change of address, phone or email updates.
  • Your insurance card(s).
  • A photo I.D.
  • The contact information for your referring physician.
  • A current list of all medications and dosages.
  • A current list of any vitamins, herbs or supplements you’re currently taking.
  • A list of any known allergies.

MLEC Patient Registration Packet

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Procedure Prep Instructions

Colonoscopy Prep Instructions AM

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Colonoscopy Prep Instructions PM

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Colonoscopy Prep Instructions 2-Day Prep

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EGD Prep Instructions

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EGD and Colonoscopy Prep Instructions AM

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EGD and Colonoscopy Prep Instructions PM

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Flexible Sigmoidoscopy Instructions – Magnesium Citrate

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Flexible Sigmoidoscopy Instructions – Miralax

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