New Patient
Forms
Welcome to Gainesville OBGYN! On this page you will find the five forms we collect from all new patients. Getting started is easy!
Step 1
First, print all five forms. You should have one of each of the forms listed below:
Health History Form
Medical Records Release Form
Financial Responsibility Form
HIPAA Release Form
Patient Demographics + Insurance Form
UCF Consent Form
Step 2
Next, fill each form out to the best of your ability.
You will be asked for medical info, history, insurance info, etc. If you have questions, call our office at 352-371-2011 and a medical expert will assist you.
Step 3
Lastly, bring your completed forms to your first appointment!
Be sure to arrive 15 minutes early so we can review each form and answer any additional questions you may have.
Click the Download > button under each form to open it. From there you can download the form OR print it directly from the web page.
Health History Form
Download >
Medical Records Release Form
Download >
Financial Responsibility Form
Download >
HIPAA Release Form
Download >
Patient Demographics + Insurance Form
Download >
UCF Consent Form
Download >
Questions?
Above all, our team of medical experts is here to answer any question you have. Simply call our office to speak with a friendly member of our staff.
Schedule your appointment today
High-quality, hassle-free medical care is just a phone call away.
6440 W Newberry Rd, Suite 502
Gainesville, FL 32605
P: 352-371-2011
F: 352-384-3611
Mon-Thurs: 8am-5pm
Fri: 8am-12pm
