Patient Forms

Check-In Procedures

Please arrive at least 20 minutes early to your new patient appointment. For your first visit to Women’s Health Center of Reno we ask that you bring the completed new patient paperwork, your photo I.D. , your most recent Insurance Card, the Name and Address of your preferred pharmacy and a list of current medications.

All co-pays and deductibles are due at the time of check in.

Please click and download the relevant forms below.

New Patient Medical History ENGLISH
Patient Authorization Form ENGLISH
Patient Registration ENGLISH
Information Disclosure Consent ENGLISH
HIPAA and Release of Information ENGLISH
Acknowledgement of Possible Lab and Pathology Charges ENGLISH

New Patient Medical History SPANISH
Patient Authorization Form SPANISH
Patient Registration SPANISH
Information Disclosure Consent SPANISH
HIPAA and Release of Information SPANISH
Acknowledgement of Possible Lab and Pathology Charges SPANISH