A number of factors including reimbursement have produced a demand for endoscopy to be performed in an office based setting as compared to a hospital or ambulatory center setting. Many gastrointestinal endoscopy procedures can be performed safely in the office setting. To ensure that patients having endoscopy in an office setting have the appropriate level of safety and quality, standards of care need to be set and met. These standards should be similar if not the same as the standards set for an institutional setting.