Our Office

Forms & Policies

Before your appointment, quickly and conveniently access the patient forms provided below.

Please print, complete and bring the forms noted below to your next appointment. In addition remember to bring your Photo ID, your insurance card and your co-payment (if applicable).   Annual forms and insurance cards/picture IDs need to be brought to each annual appointment.

Download Patient Forms

To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.

New Gyn Patient Forms

To be filled out by all new patients, as well as patients who have not been seen at the office for more than 3 years.

• Patient Registration Form
• Notice of Privacy Practices
• Acknowledgement of Notice of Privacy Practices
• Authorization
• GYN Information
• Labcorp Notice

New Ob Patient Forms

For new obstetrical patients, or for current patients who are starting a new pregnancy.

• Patient Registration Form
• Notice of Privacy Practices
• Acknowledgement of Notice of Privacy Practices
• Authorization
• GYN Information
• Labcorp Notice
• AIDS and Pregnancy
• Prenatal/Genetic Screening Questionnaire
• Trident Hospital Delivery Notice

Annual Paperwork

For current patients.

• Patient Registration Form
• Notice of Privacy Practices
• Acknowledgement of Notice of Privacy Practices
• Authorization
• GYN Information
• Labcorp Notice

Records Release

Please fill out one of these forms to have records faxed to or from Seasons OB/GYN. If having records faxed from Seasons to another doctors office, please allow three to five days. We cannot send faxes which are more 15 pages.

• Medical Records Release