Your time is valuable. So for your convenience, our patient information sheets are available online for you to print and fill out before your appointment. Just bring the completed form with you and this will minimize your wait time in the office. Please arrive at least 20 minutes early for your scheduled appointment time in order to complete/update any information. Please be aware that if you are more than 15 minutes late for your appointment, you may have to reschedule. We cannot always work you back in to the schedule on the same day, due to the busy nature of the practice, and the consideration of our other patients that do arrive on time.

Please make sure that EVERY line is completed, and if a question does not apply, then put N/A on blank line next to it.

Thank you,
The Staff at The OB-GYN Place, P.A.



 Patient Information Form
 Medical Record Release FROM Our Office
 Medical Record Release TO Our Office
 HIPPA - English
 HIPPA - Spanish
 Todays Visit - NEW Patients Only
 Todays Visit - EXISTING Patients seen more than a month ago




 PHARMACY/PRESCRIPTION RENEWAL
    Routine prescriptions are filled at your annual visits.
    If you need your prescription refilled, have your pharmacy fax us a request - (972) 772-3834
    You will need to have your prescription information available for the pharmacy.

    Routine prescriptions are not considered an emergency and generally will not be refilled after normal office hours or on weekends.

PAYMENT POLICY
   The OB-GYN Place P. A. participates in most managed care plans. If the name of our physicians appears in your book of providers, the office will accept your plan. Additionally, the office is a fully integrated practice and the physicians do not compete with one another financially. This allows us to put patient care needs first and to work together to provide the best service. Payment and copayment must be rendered at the time of your visit. For your convenience, our office accepts Visa, MasterCard, Discover, and American Express.

Major insurance carriers that we accept include:
UnitedHealthCare
BlueCross/BlueShield
Aetna
Cigna
Humana
PHCS/Multiplan
Tricare Standard
Medicare

SURGERY POLICY
If you require surgery, our surgical coordinator will verify your insurance coverage in advance and give you a call to discuss your coverage. We will also verify any pre-certification requirements. We will coordinate all of your surgical needs.





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The OB-GYN Place, located in Rockwall, Texas, serves the Dallas-Fort Worth Metroplex including:
Rowlett, Garland, Mesquite, Fate, Heath, Royse City, Greenville, Terrell, Wills Point, Canton, Kaufman, Forney
OBGYN, gynecology, physicians
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