FORMS FOR YOUR APPOINTMENT
Looking to save time? We ask all our patients to come prepared for their appointment, including the paperwork. Locate the appropriate forms below, print and complete them before you arrive at our office. You may still be asked for some information and signatures, but this will reduce the time spent on paperwork before your appointment.
Are you new to our practice? If you have never seen our physicians before, please use the following forms:
New Patient, Annual Exam
New Patient, GYN Exam (other than Annual Exam)
New Patient, New OB Exam
Have you seen our doctors before? If you have records in our office, please use the following forms:
Established Patient, Annual Exam
Established Patient, GYN Exam (other than Annual Exam)
Established Patient, New OB Exam
Notice of Privacy Practices (HIPAA)
Records Release
Occasionally, we will ask you to authorize another physician's office to provide us with your medical records. Due to privacy policies, you will need to request those documents with a form and your signature. The following form can be printed at home, completed and submitted to your outside physician's office. This form grants them your permission to release your records to our office. They may ask you to hand-carry them to our office. In the event they mail or fax your records, please check with us to make sure the records have arrived in our office before your appointment.
Records Release-Lafayette office
Records Release-Thornton office
