Before your visit: patient forms
We’re excited to welcome you to your next Austin obgyn visit and are eager to get to know you and your needs.
To help us learn as much as we can about you and your medical history, we ask that you complete a series of patient forms before your visit. Depending on the reason for your visit, you may be asked to complete additional forms that are relevant to your medical condition or concern.
For your convenience, our Austin obgyn practice offers a secure, online portal where you can quickly complete and instantly submit all registration and health history forms.
Printable patient forms
Should the portal be unavailable, we also provide patient forms that you can download and print:
- Pelvic Pain Assessment
- Minor Consent
- Release of Records
- Patient Survey
- Notice of Privacy Practices (HIPAA)
- Release of Information to Family and Friends
- Family and Medical Leave Act (FMLA)
- Family Cancer History Questionnaire
- Request for Restriction of Protected Health Information
Once you have completed and printed the necessary forms, please fax them to us at (512) 479-0906 or bring them with you to your appointment. A secure fax line protects your privacy.
If any of your personal demographic information has changed – such as your name, address or insurance provider – please be sure to inform us before your next appointment. We ask that you please submit a copy of your new insurance card before your appointment so that we may verify your benefits prior to your arrival.
If you should have questions about any of the information in our patient forms, please contact our Austin obgyn office.