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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.
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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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