Forms Needed for Your Visit
Below are forms for you to have filled out prior to your visit at Camelback Women’s Health.
By clicking on a form, it will automatically open for you. You will need Adobe Acrobat Reader, which is free, to view the forms. Once the form is open in Reader, simply print it to your printer and fill it out.
***Bring these completed forms with you on your next visit. The information does not pre-populate into our system.***
- New Patient Information Packet- Complete
- Authorization for the Release of Medical Records
- Authorization for the Release of Medical Records (Spanish)
- Authorization to Share Personal Protected Information
- Authorization to Share Personal Protected Information (Spanish)
- Financial Agreement
- Financial Agreement (Spanish) /Acuerdo Financial
- Health History
- Health History (Spanish)
- Patient Information
- Patient Information (Spanish)
- Notice of Privacy Practices
- Notice of Privacy Practices (Spanish)
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.