To make your office visit with Riverside Women’s Care go more smoothly, you may access new patient forms in advance. Please select and print the forms below, fill them out completely and bring them with you to your appointment. If you are not able to complete the forms before your visit, please allow at least 30 minutes for completion in the office before you see the doctor.
In addition to the forms, you will need to bring the following:
- Driver’s License or a valid picture ID
- Insurance card(s)
- Relevant records from your referring doctor or emergency room visit
New Patient Packet
(Please print and complete the eight (8) documents linked below):
- New Patient Information
- Patient History Questionnaire
- Authorization to Release Healthcare Information
- Consent to Contact
- Financial Policy – Explains payment of services
- Acknowledgement of Receipt of Privacy Practices – The Health Insurance Portability Act (HIPAA) requires all patients to complete this form each year.
- Notice of Privacy Practices (NPP) – The Notice of Privacy Practices (NPP) describes how medical information about you may be used and disclosed and how you can access this information.
- Patient Portal