Patient Forms
In order to speed the admission process, we have offered the following forms below. Please print and complete the below forms and bring them with you to your procedure.
Medication List![]() |
Patient History Form![]() |
Specific Procedure Instructions
Please find below any applicable instructions for your Physician or Practice.
Table of Contents
- Digestive Associates of Ohio (Gordon Kim, D.O.; Tasos Manokas, D.O.; Adam Tzagournis, M.D.; John Tzagournis, M.D.; and Michael Tzagournis, M.D.)
- Ohio Digestive Care (Jeffrey Lefkovitz, M.D.)
Ohio Digestive Care
Jeffrey Lefkovitz, M.D.
AM Miralax Bowel Prep![]() |
PM Miralax Bowel Prep![]() |
OSMOPREP Instructions![]() |
Digestive Associates of Ohio
Gordon Kim, D.O.; Tasos Manokas, D.O.; Adam Tzagournis, M.D.; John Tzagournis, M.D.; and Michael Tzagournis, M.D.
DAO Plenvu Bowel Prep
DAO EGD Prep![]() |
DAO FLEXSIG Prep![]() |
DAO MIRALAX Prep![]() |
DAO Prepopik Prep![]() |
DAO Suprep Prep![]() |
DAO Trilyte Prep![]() |