In order to provide optimum healthcare, we ask that you complete paperwork telling us about yourself and the types of services you would like to receive. Completing these forms before your visit saves time at the Center and allows you privacy and access to information you may not have expected to need.
Please download, print and fill out the forms below and bring them with you to your visit.
NEW PATIENTS
- Female Forms Packets:
- GYN Exam/"Annual": under 40 or 40 and over
- STI Screening
- Pregnancy Test
- Male Forms Packet: STI Screening
- Medical Records Release
- Far Northeast Packets:
- GYN Exam/"Annual": under 40 or over 40
- STI Screening: Male or Female
- Pregnancy Test
RETURNING PATIENTS
- Female Medical History (complete for your Annual Exam)
- Female Additional Medical History (age 40 and over)
- Female STI Screening
- Male STI Screening
- Pregnancy Test
Depending on the reason for your visit, you may have more or different forms to complete. If you are unsure which forms you'll need, call your Health Center.
