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Clinical Forms

Clinical Forms

In order to support hemorrhoid banding at your practice, the following documents are provided for download. Those documents marked with a blue “W” are available for download in Microsoft Word to facilitate the use of your own letterhead and customized content.

Patient Handouts

Post-Band Patient Instructions
Patient Education – Nitroglycerin Ointment
Patient Questionnaire
Fiber Supplements
Treatment of Pruritus Ani/Rashes
Anal Fissures
External Hemorrhoids

Clinical Staff Documents

Chart Note
Abbreviated Chart Note
Super Bill (ICD-10)
Cheat Sheet
Prescription Medication Sheet
Information for Cross Covering Providers
Billing Information
Procedure Note Template
Clinical Pearls
Policy and Procedure Guidelines

Compare CRH O'Regan System

Versus Other Hemorrhoid Treatment Options

Our account management team has over 20 years combined experience in operations, marketing and staff education for hemorrhoid banding with the CRH O’Regan System®.

If you’re a current customer, contact us today to schedule a consultation.

If you’re not utilizing the CRH O’Regan System, contact us to learn more!

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