Patient forms
Print and fill out 6 forms below (*** required forms***) before your visit to save time or send forms electronically to our HIPAA compliant email at praxis@praxisurogyn.com. We apologize for the number of papers, but they are legal requirements in California.
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***New Patient Forms***
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***Legal Forms to Review***
New patients should review and fill out forms with *** noted:
Privacy Policies (review only)
***Privacy Policy Acknowledgement***
***Financial Policies***
***Medical License Notice***
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Condition Specific
Have a bladder problem? Please complete a Bladder Diary before your first visit.
Concerned you might have Interstitial Cystitis/Bladder Pain Syndrome? Please complete this survey.
To view the forms, you will need the free ADOBE READER.