Instant Medical History Information
Click the link above to fill out the electronic medical records. This is our preferred method to update your own medical records.
History Templates Offered:
- Medical
- Surgical
- Family
Who receives this link:
- New OB Visits
- Established Initial OB Visits
- New Well Woman
- Established Well Woman
- Post-Partum
Established Patients Receive:
- Initial OB Survey for that event type
- Annual GYN Survey for that event type
- ROS Survey for every other event type, including Virtual Visits
New Patients Receive:
- New (Histories) and Initial OB Survey for that event type
- New (Histories) and Annual GYN Survey for that event type
- ROS Survey for every other event type
PDF Forms
- Demographic Update
- HIPAA Form (mandatory every 12 months)
- Communication Consent
- Patient History Form
- Genetic Screening for Cancer Questionnaire
- Annual Health History Form
- Self Pay Office Fees
- Self Pay OB Pricing (Prior to 21 Weeks Gestation)
- Self Pay OB Pricing (21-24 Weeks Gestation)
- Self Pay OB Pricing (25-28 Weeks Gestation)
- Self Pay OB Pricing (29-32 Weeks Gestation)
- Self Pay OB Pricing (33-36 Weeks Gestation)
- Self Pay OB Pricing (After 37 Weeks Gestation)
- Next Gen Mobile Consent Form
- No Show Consent Form