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Thank you for choosing Piedmont OB/GYN for your gynecological and/or obstetrical care. Below you will find links to three forms that could be completed in anticipation of your upcoming appointment. Please print them through your browser and bring the completed forms to your first visit. If you are under 18 years of age at the time of your appointment, a legal guardian must be with you for the appointment to give us consent for treatment. Please call our office at 828-322-3017 if you have any questions. Thank you for helping us make your visit a pleasant experience. We look forward to seeing you. ****************************************************************************************** REGISTRATION FORM: Should be completed by all. PRIVACY PRACTICES ACKNOWLEDGMENT: Should be completed by all. By signing the form, you agree you have had the opportunity to read our Notice of Privacy Practices. FORM C: For release of medical records. This should be filled out by those who have been seen by another doctor for anything other than routine yearly exams. You may make copies if you have been seen by more than one doctor.
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CopyrightŪ 1999-2006 Piedmont Obstetrics and Gynecology. All rights reserved. |