General Patient Forms and Information
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The following information and forms are available below for your convenience
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Surgery Information
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Pre-Op Information
COMING SOON...... 
Pre-Op Instructions
Download File Post-Op Information
COMING SOON....... 
Post-Op Instructions
Download File |
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Patient PrivacyOur notice of privacy practices can be downloaded here.
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Update Patient InformationIf you would like to update your patient information (i.e. phone numbers, address, or insurance information), please fill out the form below, and either mail, fax, or bring it to the office.
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Disability Form InformationFor private disability insurance, please contact your insurance company directly. California state disability claims are filed with the state of California Employment Development Department (EDD). California state disability insurance is covered through two benefits: Disability Insurance (DI) and Paid Family Leave (PFL). To get more information on state disability insurance, or begin the process to file a claim, please visit EDD at the link below.
Link to EDD: http://www.edd.ca.gov/Disability/ The Partnership for Women's Health has worked hard to provide our patients with quality healthcare in a caring and professional manner. During that time, we have always provided administrative services for our patients at no additional cost. Despite the increasing amount of administrative work and costs that third party payer systems have created, we have resisted passing along these costs to our patients. Unfortunately, increasing expenses within the world or health care make it difficult for us to continue to simply absorb these losses. It is important to understand that these forms have become increasingly more complex and occupy a fair amount of time of both employees and medical providers as well as incur the cost associated with copying. In most cases, the medical record needs to be obtained and carefully reviewed before the appropriate disability information can be captured. The form then needs to be completed accurately, copied, signed and returned to the chart. Our fees are designed to offset the labor costs associated with this process and continue to provide this valuable convenience to our patients. We believe that by implementing these changes we will ultimately be better able to serve the needs of our patients by focusing and investing our finances and efforts specifically on patient related health care services. |
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Medical Record Release FormIf you would like to request a copy of your previous medical records to be transferred into or out of our office, please download this form. You may either fax the form, mail the from, or bring it to our office.
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