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2200 18th Street, Bakersfield, CA. 93301
Tel: 661-323-7854
New Patient Forms
All Patient and Medical Release Forms
Welcome to the office
New Patient GYN & OB Forms
Please complete the correct New Patient Forms and bring all forms with you to your appointment, along with your insurance card/cards and a form of payment for your co-pay. Filling out these forms in advance can save you time in the waiting room.
Medical Records Release Form
Below is our Medical Records Release Form. In order to have your records securely transferred to and from a medical provider, we ask that you simply print out this form, sign, print and date at the bottom and fax it to our office at 661-323-3384. Thank you.
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