General Forms

• Notice of Privacy Practices
• Health Information Release (Medical Record Release)

New Patient Forms

(download, complete and bring to your appointment)

• Patient Registration Form
• Consent Form
• Financial Policy Form

Pelvic Pain & Sexual Medicine Forms (for Melissa Dahir patients only)

(if these forms are required for your visit and you are a new patient, please also complete all "New Patient Forms" above)

• Female Medical History Form
• Male Medical History Form

Obstetric Forms/Information

• First Trimester Screening
• Medications that are SAFE in Pregnancy
• Tips to Avoid Nausea and Vomiting in Pregnancy
• Parvovirus & CMV in Pregnancy
• Nutrition and Pregnancy
• Neural Tube Defect Screening

Gynecologic Forms/Information

• Pelvic Floor Exercises (Kegel’s)
• Calcium / Vitamin D Recommendations

Patient Instructions

• Instructions for SQ Injections
• Instructions for Intramuscular Injections
• Instructions for Taking Birth Control Pills Continuously