Patient Forms

Printable New Patient Forms for your convenience

Prior to your first visit, please download the following patient forms:

Health Questionnaire
New Patient Information
Patient Information & Authorization
Financial Policy
*Acknowledgment of Privacy Practices

*Prior to signing the “Acknowledgement of Privacy Practices” (see link above) please read the HIPAA Notice of Privacy Practices.

Please print, fill out and bring these forms to your first appointment. You should also bring your insurance card. We will need to copy it for our records.

When being referred by another physician, please bring copies of your medical records and test results.

If you have finished all this paperwork, please arrive 15 minutes prior to your appointment. If not completed, you will need to arrive 45 minutes early to be ready for your scheduled time.

Please call us at least 24 hours in advance if you need to cancel or change your appointment.

 

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Medical Records Release Forms

Release medical records from another office to The Women’s Health Center

Release medical records from The Women’s Health Center to another office

 

Welcome

The Women’s Health Center is a leading OB/GYN practice in Fountain Valley, California. Women from throughout Orange County and Los Angeles have access to expert gynecological and obstetrics services including pap smears, contraception and birth control, pregnancy and prenatal services, ultrasounds, STD testing, breast cancer and cervical cancer screenings, and minimally invasive surgeries. Women can find treatments for conditions including abnormal bleeding, UTIs, PMS, HPV and other sexually transmitted diseases, and fibroids.

The doctors at The Women’s Health Center are dedicated to providing excellent and individualized care to each of their patients. For over 20 years, the clinicians have been providing care and understanding to the women of Southern California at all stages of their lives. From pediatric gynecologic problems to menopause, women’s needs and health care is put first. The team of physicians and staff are passionate about providing the right care at the right time and ensuring that each and every patient receives the personal care and attention necessary.

The Women’s Health Center is currently welcoming new patients. Most major forms of insurance are accepted.

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The Women's Health Center

The Women’s Health Center is a leading OB/GYN practice in Fountain Valley, California. Women from throughout Orange County and Los Angeles have access to expert gynecological and obstetrics services including pap smears, contraception and birth control, pregnancy and prenatal services, ultrasounds, STD testing, breast cancer and cervical cancer screenings, and minimally invasive surgeries. Women can find treatments for conditions including abnormal bleeding, UTIs, PMS, HPV and other sexually transmitted diseases, and fibroids.

The doctors at The Women’s Health Center are dedicated to providing excellent and individualized care to each of their patients. For over 20 years, the clinicians have been providing care and understanding to the women of Southern California at all stages of their lives. From pediatric gynecologic problems to menopause, women’s needs and health care is put first. The team of physicians and staff are passionate about providing the right care at the right time and ensuring that each and every patient receives the personal care and attention necessary.

The Women’s Health Center is currently welcoming new patients. Most major forms of insurance are accepted.


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Location
The Women's Health Center
9940 Talbert Avenue, Suite 303
Fountain Valley, CA 92708
Phone: 714-462-1348
Fax: 714-378-5621
Office Hours

Get in touch

714-462-1348