New Patients

No form settings found. Please configure it.

Paperwork

On your first visit to Serenity Gynecology and Functional Medicine you will need to bring your

  • Driver License/Photo ID
  • Insurance Card(s)
  • Co-pays, co-insurance and deductibles which are due at the time of service

For General Gynecology visits click the links below to print out your patient forms and have them completed at the time of your visit. If unable to fill them out at home please arrive 20 minutes early to complete. If not completed we may have the right to reschedule.. MEDICARE is not accepted at this time, but we do offer special pricing for self pay patients.

ALL APPOINTMENTS MUST BE CONFIRMED. Our office will contact you to confirm your appointment. Appointments not confirmed may be rescheduled by our office. Please respond with confirmation at least 24 hours prior to your appointment.

You have the option to print the forms and bring the completed forms to your appointment or you can scroll down to the ONLINE PATIENT FORMS below  and click on each one of the three links and your information will be sent to our office securely electronically.

We do not require the Medical Records Release be completed unless we need to request records from another office. 

When printing the Notice of Privacy Forms print only the signature page .

Print these forms and complete to bring to office:

Privacy Forms  (Complete if you are needing records transferred only)

For More Information or To Make An Appointment Please Fill Out The Form Below And Someone From Our Office Will Call You

Communications through our website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use. Please visit our Privacy Policy for more information.