Gyne Patients Only

Thank You for Choosing Us

Thank you for choosing the Family Fertility Center for your gynecological care. We take great pride in operating as a team to provide quality health care to all of our patients.

Getting Ready for

Your First Visit

Firstly, complete and bring the following forms (7 total) with you at your first visit.

To begin, click here to print all seven (7) forms.

• New Patient Demographics Form
• Your Financial Responsibility Form
• Pharmacy Benefit Pre-Verification Form
• Patient Communication Instructions
• Receipt of HIPAA Notice
• Insurance Coverage For Laboratory or Radiologic Testing
• Gynecology Health History

Secondly, other documents you should read before your first visit are:

• Patient Rights and Responsibilities
• Notice of Privacy Practice – commonly called HIPAA

Lastly, bring the following items with you at your visit:

• Valid drivers’ license or state-issued photo ID
• Health insurance card
• Prescription card
• Special referral or pre-authorization form from your primary care provider, if required by your health plan

Before Your First Visit

Request past medical records

Have you been diagnosed with a specific gynecological disease elsewhere or undergone any gynecological surgery? If so, please request copies of those medical records and bring them along to your initial consult. Additionally, a Patient Request for Medical Records form is available here for your convenience.

Contact your insurance

In some instances, our physician may deem it appropriate and medically necessary to perform an ultrasound. This, in addition to possible blood testing, may be necessary in order to adequately diagnose a specific gynecological problem. PLEASE CONTACT YOUR INSURANCE TO DETERMINE IF ULTRASOUND AND HORMONE BLOOD TESTING CAN BE PERFORMED IN THE SPECIALIST’S OFFICE. If not, please tell us the name of the specific radiology facility and laboratory you must use. Also, ask your insurance if any special referral/preauthorization will be necessary for more certain radiology services. For example, MRI or CT scans.

Prepare for your first visit

So, if you have specific questions or concerns, write them down and bring along at your first visit. Above all others, an informed patient is the most efficient and satisfied consumer of healthcare.