Patient Forms
Patient Forms
Authorization for Release of Medical Information
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
Authorization for Release of Medical Information
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
Authorization and Consent for Treatment
All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
Authorization and Consent for Treatment
All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
Authorization and Consent for Treatment
All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
Authorization for Release of Medical Information
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
Authorization for Release of Medical Information
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
Preferred Contacts
Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.
Preferred Contacts
Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.
Preferred Contacts
Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.
Virtual Visit Policy
This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Virtual Visit Policy
This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Virtual Visit Policy
This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Office Policies
Office Policies
Office Policies
Financial Policy
This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.
Financial Policy
This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.
Notice of Privacy Practices
Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.
Authorization and Consent for Treatment
All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
Notice of Privacy Practices
Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.
Authorization for Release of Medical Information
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
Authorization for Release of Medical Information
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
HIPAA Privacy Notice
This Notice is provided to you pursuant to the privacy regulations enacted as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
HIPAA Privacy Notice
This Notice is provided to you pursuant to the privacy regulations enacted as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
HIPAA Privacy Notice
This Notice is provided to you pursuant to the privacy regulations enacted as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
FAQ
FAQ
FAQ
Quick & Clear Answers
Quick & Clear Answers
Quick & Clear Answers
Appointments & Scheduling
Appointments & Scheduling
Do you offer telemedicine consultations?
Yes. We offer virtual visits through Privia’s secure telehealth platform, allowing you to connect with your doctor for follow-ups, medication reviews, and certain gynecologic concerns — all from home.
Do you offer telemedicine consultations?
Yes. We offer virtual visits through Privia’s secure telehealth platform, allowing you to connect with your doctor for follow-ups, medication reviews, and certain gynecologic concerns — all from home.
Do you offer telemedicine consultations?
Yes. We offer virtual visits through Privia’s secure telehealth platform, allowing you to connect with your doctor for follow-ups, medication reviews, and certain gynecologic concerns — all from home.
How can I book an appointment?
How can I book an appointment?
How can I book an appointment?
What should I do before my first visit?
What should I do before my first visit?
What should I do before my first visit?
What should I bring to my appointment?
What should I bring to my appointment?
What should I bring to my appointment?
Are there cancellation or no-show fees?
Are there cancellation or no-show fees?
Are there cancellation or no-show fees?
What if I arrive late to my Appointment?
What if I arrive late to my Appointment?
What if I arrive late to my Appointment?
Do you offer same-day or urgent appointments?
Do you offer same-day or urgent appointments?
Do you offer same-day or urgent appointments?
Are emergency services available 24/7?
Are emergency services available 24/7?
Are emergency services available 24/7?
Insurance, Billing & Payments
Insurance, Billing & Payments
Do you accept insurance?
Do you accept insurance?
Do you accept insurance?
What payment methods do you accept?
What payment methods do you accept?
What payment methods do you accept?
Do you require a credit card on file?
Do you require a credit card on file?
Do you require a credit card on file?
How do prescription refills work?
How do prescription refills work?
How do prescription refills work?
Medical Access & Communication
Medical Access & Communication
How do I access my test results?
How do I access my test results?
How do I access my test results?
Can I message my doctor online?
Can I message my doctor online?
Can I message my doctor online?
Locations & Care Logistics
Locations & Care Logistics
Where are you located?
Where are you located?
Where are you located?
Which hospitals are you affiliated with?
Which hospitals are you affiliated with?
Which hospitals are you affiliated with?
Obstetric & Gynecologic Care
Obstetric & Gynecologic Care
Do you deliver babies?
Do you deliver babies?
Do you deliver babies?
Do you see adolescent or teen patients?
Do you see adolescent or teen patients?
Do you see adolescent or teen patients?
What if I need surgery?
What if I need surgery?
What if I need surgery?
Do you offer menopause and hormone therapy support?
Do you offer menopause and hormone therapy support?
Do you offer menopause and hormone therapy support?
Services & Conditions
Services & Conditions
What are your core services?
What are your core services?
What are your core services?
What are your top treated conditions?
What are your top treated conditions?
What are your top treated conditions?
JOIN THE PRACTICE
JOIN THE PRACTICE
JOIN THE PRACTICE
Your Personalized Women’s Care Starts Here
Your Personalized Women’s Care Starts Here
Your Personalized Women’s Care Starts Here
Join our practice for high-touch, attentive OB/GYN care designed around your health, comfort, and long-term wellbeing.