Patient Forms

On your first visit to Laramie Physicians Women & Wellness Clinic, you will be asked to fill out a few forms to help in your care and treatment and to ensure that your rights as a patient are protected. Below are a few helpful forms to review and fill out. Please bring these completed forms to your visit. This will help expedite your check-in process. Forms will also be available at our office or can be emailed to you if requested. To view the forms listed below, you will need Adobe Reader.

FEMALE GYN PATIENT FORMS

*New Patients will need to complete all forms below

Women’s New Patient Paperwork

Records Release

Medication Refill Policy

Telehealth Consent Form

Notice of Privacy Practices- English

Notice of Privacy Practices- Spanish

MALE PATIENT FORMS

*New Patients will need to complete all forms below

Male New Patient Paperwork

Records Release

Medication Refill Policy

Telehealth Consent Form

Notice of Privacy Practices- English

Notice of Privacy Practices- Spanish

OB PATIENT FORMS

*New Patients will need to complete all forms below

OB New Patient Paperwork

Records Release

Medication Refill Policy

Telehealth Consent Form

Notice of Privacy Practices- English

Notice of Privacy Practices- Spanish