Jill Whitfield examines a pregnant mother

“I felt so cared for.”

Patient Forms

Paperwork can sometimes be overwhelming at registration time if you are new to the practice. To help facilitate the process, we have provided forms that you can print out and complete prior to your visit.

You will need Adobe Acrobat Reader to open and print these files.  This will help reduce the time you spend in the waiting room.

Please note that there are forms for the New OB (pregnant) clients and the New GYN (non-pregnant) clients.  Click the corresponding link below to download your appropriate forms.

Please remember to bring these completed forms to your appointment.  We will also need a current copy of your insurance card and a picture ID.

New OB (pregnant) Forms

New GYN (non-pregnant) Forms

Well-Care Visit Form

Insurance Verification for Pregnant Clients

We are using Larsen Billing Service to handle the verification of benefits.  Use the information below to help you walk through the process.

STEP 1 : Download the Guide to Verification of Benefits with Larsen Billing Service – Verification of Benefits Instructions

STEP 2 : Go to Larsen Billing Service to complete your verification of benefits.  The instructions in the Verification of Benefits Instructions document will walk you through the steps you need to follow on their website. (The Birth Centers PIN number: 12324)


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