| Bluefield Women's Center | |||||
| Obstetrics & Gynecologic Medical Services | |||||
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| Forms and Handouts | |||||
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| These forms are in Adobe Reader PDF format | |||||
| Download & complete forms prior to your visit. | |||||
| All pages must be completely filled out, | |||||
| and handed in. (signed) | |||||
| Adobe Reader is required to access these forms. | |||||
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| PATIENT_INTAKE_FORM (PDF) | |||||
| PATIENT_REGISTRATION_SHEET (PDF) | |||||
| Consent_to_Use_PHI_for_TPO (PDF) | |||||
| HMO_PCP_FORM (PDF) | |||||