INFORMATION FOR OUR PATIENTS:
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Gulf Coast Endoscopy and Surgery Center’s management and staff care about the treatment their patients receive. If at any time we fail to meet your expectations, please feel free to ask for the administrator or supervisor on duty.
Administrator:
Terri Lopez, CASC
941.484.5000, ext 1009
tlopez@gulfcoastendocenter.com
We are required under the provisions of Florida Patient’s Bill of Rights and Responsibilities to inform those patients who inquire regarding filing of complaints with the State of Florida the following information:
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Complaint Against Health Care Professional or Facility
Florida Department of Health
Consumer Services Unit
4052 Bald Cypress Way, Bin C-75
Tallahassee, FL 32399-3275
1-850-245-4339
http://www.doh.state.fl.us/mqa/enforcement/enforce_csu.html
Consumer Assistance Notice
Agency for Health Care Administration
2727 Mahan Dr
Tallahassee, FL 32308
1-888-419-3456
The Department of Insurance State of Florida Abuse Registry
200 East Gaines St. 1-800-96-ABUSE
Tallahassee, FL 32399
1-877-693-5236
Office of the Medicare Beneficiary Ombudsman:
https://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html
The Gulf Coast Endoscopy Center’s Patient Grievance Policy can be found in our patient packet, on our website or by calling the Center.
If you need the address and toll-free telephone number of the grievance department of any of our contracted HMOs, please ask one of our business office employees.
Quality measures and statistics that are disseminated by the State of Florida Agency for Healthcare Administration pursuant to s.408.05 F.S. are available at www.Floridahealthfinder.gov
DOCUMENTS FOR YOUR REVIEW
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Advance Directives - English
Advance Directives - Spanish
Aetna Non-Covered Service Waiver
Anesthesia Consent Form
Authorization Form
Colonoscopy Consent
Colonoscopy EGD Consent
EGD (Upper Endoscopy) Consent
Eye Procedure Consent
Flexible Sigmoidoscopy Consent
Flexible Sigmoidoscopy EGD Consent
Notice of Privacy
Patient's Bill of Rights Summary