New Patient

Forms

Welcome to Gainesville OBGYN! Our friendly staff of medical experts is here to make your healthcare experience the best you’ve ever had. Getting started is easy!

1

Print all five forms:

Health History Form

Medical Records Release Form

Financial Responsibility Form

HIPAA Release Form

Patient Demographics + Insurance Form

2

Fill each form out to the best of your ability.

If you have questions, call our office at 352-371-2011 and a medical expert will assist you.

3

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.

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Health History Form

Download >

Medical Records Release Form

Download >

Financial Responsibility Form

Download >

HIPAA Release Form

Download >

Patient Demographics + Insurance Form

Download >

Questions?

No Problem! 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

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