Foos OB/GYN, PC - A Woman for Woman Care
New Patient Info & Forms
 
Thank you for choosing Foos Ob/Gyn, PC and welcome to our practice.  We look forward to developing a professional relationship with you based on the highest quality of care.  For your convenience, we ask that you complete the forms below and fax (717-724-3629) to our office no later than ONE WEEK prior to your appointment.  For your appointment to proceed as efficiently as possible, please follow these instructions.
 
  1. Please arrive 15 minutes prior to your scheduled appointment in order to get through our check in process.
  2. Please bring your insurance card.  If we do not have a copy of your insurance card, we will have to reschedule your appointment.  We cannot bill your insurance without your insurance information.
  3. It is our policy to collect co-pays, coinsurances, and/or deductibles prior to being seen. We collect payments due during our check in process.  If payment is not made, we will have to reschedule your appointment.
  4. Bring old and current records, office notes, labs, tests, and any other pertinent information to help our physicians better evaluate your health condition.
  5. Please complete and bring the forms below to your appointment.


 
NEW PATIENT FORMS:

New patient packet  (please have filled out prior to your appointment)


ESTABLISHED PATIENT FORMS:

Demographics (If you have a change of address, marital status or employment)
Health History (Please complete if you have had any changes in health)
Annual visit form
HIPPA Form




 
Please contact our office if you have any questions.  Thank you again and we look forward to seeing you.
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