OBSTETRICS & GYNECOLOGY
17722 Talbot Road South  Renton, WA 98055   425.228.0722
16850 SE 272nd Street  Covington, WA 98042  253.630.3644

PROVIDERS

LOCATION
REFILL REQUESTS
  MEDICAL RECORDS
 APPOINTMENTS
 ONLINE PAYMENTS
    BILLING
PATIENT RESOURCES  HEALTH INFO PREGNANCY INFO  VISIT SURVEY   FORMS    PRIVACY POLICY

                   
                    

 



Appointment Forms:

 

By patient request, we've made it easier to find our forms. 

Get Adobe Reader logoAll of our forms are in PDF format.  In order to open a form, you will need to have a current version of Acrobat Reader loaded on your computer.  Here is the link to obtain Acrobat Reader.  It is a free program.

For all patients at every visit, we require a piece of photo identification, as well as your medical insurance card.

For patients with DSHS/Medical Coupons, we require a current medical coupon as well as a piece of photo identification with every office visit.



Please click on the link that best describes your next visit:

õ

I am pregnant and this will be my first visit to Valley Women's Clinic
õ I am pregnant and this will NOT be my first visit to Valley Women's Clinic
õ I am NOT pregnant and this will be my first visit to Valley Women's Clinic
õ I am an established patient coming in for my annual exam and I am not pregnant
õ Other type of visit

 

 




 

FIRST VISIT FOR NEW PREGNANCY
You will need to print out and complete the following forms.   Bring them with you to your first visit.  You will also need your insurance card and a photo ID (drivers license or ID card)

There are three forms:


Patient Registration Form

Pregnancy History Form - Page One

Pregnancy History Form - Page Two

 

FIRST VISIT - GYN CARE ONLY (NOT PREGNANT)

You will need to print out and complete the following forms.   Bring them with you to your first visit.  You will also need your insurance card and a photo ID (drivers license or ID card)

There are three forms:


Patient Registration Form

Health History - Page One

Health History - Page Two

 

ESTABLISHED PATIENT - ANNUAL EXAM

You will need to print out and complete the following forms.   Bring them with you to your first visit.  You will also need your insurance card and a photo ID (drivers license or ID card)

There are three forms:


Patient Registration Form

Health History - Page One

Health History - Page Two

 

OTHER TYPES OF VISITS


Please be sure to bring your insurance card and photo ID

We will give you any forms you may need at the time of office visit

 




 

 

 

 

 

 








VALLEY WOMEN'S CLINIC, PLLC
©2009

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