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Healthy Woman Office Visit
We thank you for choosing Healthy Woman as your healthcare provider.   We will make every effort to make your experience as easy as possible.

When you come in for your appointment, you will be asked to sign several forms, including registration forms, HIPAA required forms and other office policy forms authorizing us to submit billing information to your insurance company. Each patient will also be asked to provide a urine sample at every visit. So, please come prepared by drinking adequate amounts of clear liquids prior to your visit. 


What Should I Bring to My Visit?

We ask that you bring the following to each of your appointments:

  • Current Insurance Card
  • Co-Pay (if applicable)
       
    We accept VISA, Mastercard, American Express, cash, and personal checks.
  • Referral from Primary Care Physician (if applicable)
  • Records from prior physician (if transferring to our practice and have    not already had your records sent to us)


Which forms should I print and complete?

For your convenience, we have all of the necessary forms available for you on our website.  In order to expedite the registration process, we ask that you please print, complete, and bring the forms to your visit.   If you cannot print these forms at home, they will be provided to you upon check-in.   Please reference the table below to determine which forms to print.   You can click here to access our forms page.

If you are a:

Print and Complete:

NEW PATIENT (GYN or Prenatal)
New Patient Information Packet
NEW PATIENT
(under age 18)

New Patient Information Packet
- PLUS  -
Adolescent Questionairre

NEW PATIENT
(with Medicare Insurance)

New Patient Information Packet
- PLUS  -
Medicare ABN



If you are a:

Print and Complete:

RETURNING PATIENT who:

1) Does NOT have to update info
                      - OR -
2) HAS been seen by this office within the past twelve months

Medical Services Waiver

RETURNING PATIENT who:

1) Has to update information
                      - OR -
2) Has NOT updated an information form within the past twelve months
                      - OR -
2) Has NOT been seen within the past twelve months

Patient Information Update
- PLUS -
Medical Services Waiver
- PLUS -
Authorization for Release of Protected Health Information

RETURNING PATIENT
(with Medicare Insurance)

Patient Information Update
(if necessary - see above)
- PLUS-
Medicare ABN



 
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        © 2008 Healthy Woman    |   Patient Rights

Freehold:              (732) 303 - 0888
Colts Neck:           (732) 431 - 1616
East Windsor :
   (609) 448 - 2886