Business Office Forms
For your convenience, in order to make your appointments at Men's and Women’s Specialty Health Centers as simple as possible, we have provided easier access to several of our most commonly used forms that are now available for downloading and printing. If you have any questions feel free to contact us.
The following forms are available at this time by clicking on the links provided:
- Patient Registration Form
- Billing Information
- Waiver- Filing for In-Network Benefits
- Notice of Privacy Practices
- Release of Protected Health Information
- Out of Network Physician Insurance Coverage
- Notice of Exclusions From Medicare Benefits
- Credit Card Authorization
- Available Financing Options
- Medical Record Release Form
- Out of Network Physician Insurance Coverage
- Financial Policy Agreement
