Patient Forms - English & Spanish

Patient Forms

Patient Forms

Welcome to Center For Women’s Health And Wellness. For your convenience, please print and fill out all applicable patient forms and present them to the front desk when you arrive for your first office visit.

English

Medical Release Form

Consent for HIV Testing and Authorization for Limited Release of Test Results

Consent For Minor

Depo-Provera Consent

Excuse Note

Informed Consent

IUD Consent

Consent For Removal Of IUD

Mammogram & Breast Sonogram Results

Missed Appointment – Abnormal Results

Missed Appointment – Call Back

Missed Appointment – Colposcopy

Missed Appointment – Get In Contact

Missed Appointment – Test Results

Patient Consent Form

Obstetrical Ultrasound

Pap Smear/Pathology Result

Pelvic Ultrasound Worksheet

To schedule an appointment

Unable to Reach You

Venofer (VF) Fee Policy

Spanish

Formulario de Consentimiento del Paciente

Formulario de Autorización Médica

Consentimiento De Depo-Provera

Consentimiento DIU

Consentimiento Informado

Consentimiento Para La Extracción Del IUD

Consentimiento Para Menor

Consentimiento Para La Prueba Del Vih Y Autorización Para La Liberación Limitada De Resultados De La Prueba

Venofer (VF) Fee Policy

 

Contact Center For Women’s Health And Wellness

Our Team and her team of devoted professionals go the extra mile to ensure their patients are completely satisfied after each appointment, answering any questions a patient may have. If you need a dependable OB/GYN specialist for routine gynecological care or a knowledgeable practitioner to perform a pelvic reconstructive surgery, Center For Women’s Health And Wellness is your most secure option. 

Contact Center For Women’s Health And Wellness today at (305) 595-6488 to be treated by one of the top gynecologists in South Florida or click here to schedule your first exam!