Patient Forms
Download our patient forms prior to your first appointment
New Patients
If you’re new to our practice, welcome! You’ll be joining a group of professional health care providers who specialize in women’s health. Be sure to download the forms and complete them prior to your appointment. Please fax your completed forms to 712-252-2024 to expedite your registration on your first visit. Please bring your driver’s license and insurance card(s) to your visit.
New Patient Forms
Confidentiality and Medical Records
Click here to read our complete Privacy Statement. All of your medical records are confidential and will be only released upon your written request. Please note that we cannot communicate or release medical information to family members (i.e., parents, husband) without written permission of the patient, unless the patient is a minor child.
Good Faith Estimate Notice
Financial Policy & Billing
Click here to review our financial statement outlining our policies on how we bill for your services. If, at any time, you have any questions regarding your account, treatment fees, or insurance, please speak with our billing department.