PRIVACY/REGISTRATION FORMS

Southwest Women's Health, P.A.'s relationship with its patients depends on trust, frank discussions, and PRIVACY. We follow the Federal HIPAA Standards for Privacy and Security of your health information. Our Notice of Privacy Practices will be given to you when you first come to our practice, and anytime in the future upon request. Our services in Albuquerque, NM include family planning, contraceptive options, pre and post-menopausal counseling, HRT therapies, HPV vaccines and colposcopy and surgical services.

 

TO SUBMIT FORMS PLEASE VISIT THIS PAGE ON YOUR DESKTOP COMPUTER.

 

TO DECREASE WAIT TIMES, WE RECOMMEND THAT YOU COMPLETE FORMS VIA

FAX (505) 246-9421 OR ELECTRONICALLY.

ONE WEEK PRIOR TO YOUR VISIT. WE CAN THEN ENTER YOUR INFORMATION 

PRIOR FOR YOUR APPOINTMENT.

- THANK YOU!

PATIENT MEDICAL HISTORY

NOTICE OF PRIVACY PRACTICES