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OB/GYN Patient Information Forms

WakeMed Physician Practices Obstetrics & Gynecology offers you the oppportunity to complete required patient information forms prior to your appointment. Simply click on any of the forms below to read a pdf version of the document.

 

Read these forms now, but they must be signed at our office:

 

General Consent:   This form is completed by all new patients to the Practice and yearly by established patients.  The form gives WakeMed Physician Practices OB/GYN permission to provide patient care, informs the patient of key billing practices, and explains conditions under which information is disclosed.

 

Compound Authorization  This form is completed by any patient desiring to have the Practice disclose information to a person or entity other than themselves.  It also explains the type of information that can be disclosed.  The form is updated yearly. 

 

You may print these forms, complete them in advance and bring them to our office during your visit:

 

Patient Information  This form is completed by all patients new to the Practice, and the information is entered into the computer by the registration staff.  At each visit, the patient will be asked to review the information printed off the computer and revise as needed.

 

Patient Self Health Assessment Initial Intake: This form is completed by every new patient to the Practice and gives the staff and providers basic health information and health history on the patient. 

 

Patient Self Health Assessment Follow-up Intake: This form is completed by all GYN patients who return to the Practice on an annual basis.  This is a yearly update to the Initial Intake form.