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Online Patient Resources

ONLINE PATIENT RESOURCES

We have made filling out the necessary forms quick and convenient for you. You may view them and print them out using Adobe Reader (download Adobe Reader for free at www.adobe.com). To save time, complete them and mail them to the office before your first visit or bring them with you. Item 6, our Notice of Privacy Practices, is important information for your own records.

1. Patient Registration Form (now accessible through the Summit Ob Gyn Portal Website)

2. Financial Policy

3. Maternity Financial Policy

4. Office Policy

5. Medical Records Release Request Form

6. Medical Records Release Request Form from Summit Ob Gyn

7. Notice of Privacy Practices

8. Vaccine Checklist

9. Information about Summit Ob Gyn Portal

10. Summit Ob Gyn Portal Registration Form

11. Her Option Checklist

12. Essure Pre-Procedure Information

1. Patient Registration Form (now accessible through the Summit Ob Gyn Portal Website) 2. Financial Policy 3. Maternity Financial Policy 4. Office Policy

5. Medical Records Release Request Form 6. Medical Records Release Request Form from Summit Ob Gyn