Registration

Medical History Form

To shorten your wait time at the office, complete your medical history form online to send to your provider before your office visit.

Click Here to Fill Out Patient Medical History

Hotel Accommodations

For patients needing to stay in Birmingham overnight for appointments or procedures, Birmingham Gastroenterology has partnered with Hampton Inn Birmingham/Mountain Brook to offer patients special rates. When calling to make reservations, patients should request the LNR rate for Birmingham Gastroenterology and provide the Client ID: 0003188801. Patients may also make reservations online by clicking below:

Book Your Stay at the Hampton Inn –
Birmingham/Mountain Brook

Address:
2731 US Highway 280 South
Birmingham, AL. 35223

Schedule Your Appointment Today

Name
This field is for validation purposes and should be left unchanged.
First Name*
Last Name*
Phone Number*
Email Address
Date Of Birth*
MM slash DD slash YYYY
Preferred Location:*
How did you hear about us?*
- Social Media (Facebook, IG, TikTok, etc.)
- Search Engine (Google, Bing, etc.)
- I'm a Returning Patient
- Referral from a Doctor
- Recommended by a Friend
- News Article or Event

Registration

Medical History Form

Hotel Accommodations

Schedule Your Appointment Today

Services

Quicklinks