New Patients

Obstetrics & Gynecology: Your Appointment

To schedule an appointment, call (937) 208-6810.

Registration

At each visit you will check in with the receptionist. Please inform us of any changes in your personal information as well as any changes in your insurance. We will need to copy your insurance card(s).

Download, print and complete the following forms. To view these files, you need Adobe Reader, a free download.

The Registration Form for our office will become part of your medical records. It is important that you complete all of the sections, date and sign the form. (Please bring this form with you to your first appointment. This will expedite your waiting time.)

You will also need to fill out the History Form. (Please bring this completed form with you to your appointment.)

Insurance Filing and Payment

We are happy to file your insurance for you. We strive to process each claim accurately and efficiently. Please bring your insurance card(s) with you to each visit. It is important that you know your insurance plan’s limitations. Patients whose plans have a co-payment will be required to pay the designated amount at the time of service. Obstetrics & Gynecology accepts cash, personal checks or credit/debit cards.

Checklist of What to Bring to Your Appointment