If you’re a new patient at Women’s Health Care Center of Houston, we’d like to welcome you to our practice! This section of our website is designed to answer any questions you might have, and to help you get ready for your first visit to our offices.
Before You See Us
When you check in for your first visit, we ask you to complete several forms in order to better serve you, to help you coordinate with your insurance provider on payment, and attend to your health. We’ve made them available here on the site to download and fill out prior to arriving at the office.
- Patient History and Intake Form (for all patients, gathering basic contact and insurance information – existing patients should update this form once every three years)
- Privacy Contact Form (for all patients, designating who can request information about your care, and preferred method of contact)
- Financial Policy and Contract (for all patients, detailing how we coordinate with you and your insurance company and/or Medicaid on payment)
- Acknowledgement of Receipt of Notice of Privacy Practices – HIPAA (for all patients, acknowledging that you have read our HIPAA – Notice of Privacy Practices)
- Medical Records Release to WHCCH (for all patients, allowing our office to request medical records from your prior health care providers)
- Medical Records Release from WHCCH (for all patients, allowing our office to send medical records from to your other health care providers, including specialists or other consulting care providers we work with to provide you care)
- Well-Woman Examination Form (for patients coming for well-woman annual checkups only, confirming that it is a well visit; if a patient is seeing one of our care providers for a medical issue, it can’t be classified for insurance purposes as a well-woman exam)
Obtaining Your Medical Records
To obtain a copy of your medical records, please fill out the Medical Records Release Form (click the link to download) and submit it to our offices. (We will let you know the fee amount and secure your approval prior to processing.)
If you have any questions, please contact our Supervisor of Medical Records at 713.365.2934.