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.

 

ATTENTION NEW PATIENTS

WE WELCOME NEW PATIENTS BUT WE ARE NOT CONTRACTED WITH MOLINA HEALTHCARE,

BCBS COMMUNITY PLANS OR UNM HEALTH!

 

ALL PRIVACY/REGISTRATION FORMS MUST BE RECEIVED BEFORE AN APPOINTMENT CAN BE SCHEDULED. 

Upon receipt of the forms, we will contact you by phone or email (your preference) to schedule an appointment with your chosen provider. 

 

Download the completed forms to your desktop computer and email them to PTFORMS@shodenwilliams.com

OR

You can print and submit them via secure fax (505) 246-9421 

OR

Call (505) 843-7131 for assistance

 

NOTE: You must have Adobe reader to download and complete the forms. 

Click here for directions for downloading.

 

Because this is a lengthy appointment, we will charge a $100 service fee to your credit card if you do not show up for the visit.

THANK YOU AND WE LOOK FORWARD TO MEETING YOU SOON!

 

ATTENTION EXISTING PATIENTS: PLEASE REMEMBER TO BRING YOUR MOST RECENT INSURANCE CARD, PERSONAL ID AND COPAY TO EACH VISIT AND ARRIVE AT LEAST 15 MINUTES EARLY TO CHECK IN AND DECREASE WAIT TIMES

 

– THANK YOU!

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883 Lead Ave SE
Suite A
Albuquerque, NM 87102

Tel: (505) 843-7131 | (505) 247-8820

Fax: (505) 246-9421​
 

Hours of Operation
Mon-Thu 7:30 AM - 4:30 PM
Fri - Closed

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