{"id":1110,"date":"2023-08-16T12:31:49","date_gmt":"2023-08-16T12:31:49","guid":{"rendered":"https:\/\/www.toplinemd.com\/my-gyn-care\/?page_id=1110"},"modified":"2026-01-20T16:28:48","modified_gmt":"2026-01-20T16:28:48","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/www.toplinemd.com\/my-gyn-care\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container fusion-parallax-none nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-background-position:center bottom;--awb-background-blend-mode:overlay;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:10%;--awb-padding-bottom:10%;--awb-min-height:700px;--awb-background-image:url(&quot;https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2023\/08\/patient-forms.jpg&quot;);--awb-background-size:cover;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-center fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:1352px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_3_5 3_5 fusion-flex-column fusion-animated\" style=\"--awb-padding-top:1px;--awb-bg-color:rgba(232,96,194,0.65);--awb-bg-color-hover:rgba(232,96,194,0.65);--awb-bg-size:cover;--awb-width-large:60%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.2%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.2%;--awb-width-medium:100%;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-animationType=\"fadeInDown\" data-animationDuration=\"0.6\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-one\" style=\"--awb-text-color:#ffffff;--awb-margin-top:30px;--awb-margin-bottom:30px;--awb-margin-top-small:20px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:63;line-height:1.1;\">Patient Forms<\/h1><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:5rem;--awb-padding-bottom:5rem;--awb-padding-top-medium:3rem;--awb-padding-bottom-medium:3rem;--awb-padding-top-small:2rem;--awb-padding-bottom-small:2rem;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:1352px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-width-large:66.6666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.88%;--awb-width-medium:100%;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><h4 style=\"text-align: center;\">Please click to open and download a form<\/h4>\n<\/div><ul style=\"--awb-size:18px;--awb-iconcolor:#e860c2;--awb-line-height:30.6px;--awb-icon-width:30.6px;--awb-icon-height:30.6px;--awb-icon-margin:12.6px;--awb-content-margin:43.2px;--awb-circlecolor:rgba(106,191,22,0);--awb-circle-yes-font-size:15.84px;\" class=\"fusion-checklist fusion-checklist-1 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-chevron-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\"><a href=\"\/wp-content\/uploads\/sites\/292\/2026\/01\/OFFICIAL-NEWEST-2026_FINAL_VERSION_FINAL_VERSION_NEW_PATIENT_PACKET_with_No_Show-1.pdf\" target=\"_blank\" rel=\"noopener\">New Patient Packet<\/a><\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-chevron-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\"><a href=\"\/wp-content\/uploads\/sites\/292\/2026\/01\/2026-FINAL-VERSION-Established-Patient-Demographics.pdf\" target=\"_blank\" rel=\"noopener\">Established Patient Demographics<\/a><\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-chevron-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\"><a href=\"\/wp-content\/uploads\/sites\/292\/2023\/10\/Results-No-Show-Policy-1.pdf\" target=\"_blank\" rel=\"noopener\">Results &#038; No-Show Policy<\/a><\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-chevron-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\"><a href=\"\/wp-content\/uploads\/sites\/292\/2025\/08\/FINANCIAL_POLICY.pdf\" target=\"_blank\" rel=\"noopener\">Financial Policy Form<\/a><\/div><\/li><\/ul><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 hundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-equal-height-columns wh2footerlogos\" style=\"--awb-border-sizes-top:0px;--awb-border-sizes-bottom:0px;--awb-border-sizes-left:0px;--awb-border-sizes-right:0px;--awb-border-color:#e860c2;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-background-color:#f0f3f6;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last fusion-column-no-min-height\" style=\"--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-border-color:#e860c2;--awb-border-bottom:15px;--awb-border-style:solid;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first wh2footerlogo\" style=\"--awb-padding-top:40px;--awb-padding-left:12%;--awb-bg-blend:overlay;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element in-legacy-container\" style=\"--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><a class=\"fusion-no-lightbox\" href=\"\/my-gyn-care\/\" target=\"_self\" aria-label=\"270&#215;100 my gyn care\"><img decoding=\"async\" width=\"270\" height=\"100\" src=\"https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2023\/11\/270x100-my-gyn-care-1.png\" alt class=\"img-responsive wp-image-1178\" srcset=\"https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2023\/11\/270x100-my-gyn-care-1-200x74.png 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srcset=\"https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2026\/04\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-200x48.png 200w, https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2026\/04\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-400x95.png 400w, https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2026\/04\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-600x143.png 600w, https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2026\/04\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-800x191.png 800w, https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2026\/04\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-1200x286.png 1200w, https:\/\/www.toplinemd.com\/my-gyn-care\/wp-content\/uploads\/sites\/292\/2026\/04\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color.png 1576w\" sizes=\"(max-width: 1000px) 100vw, 600px\" \/><\/a><\/span><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":13,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-1110","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.1.1 - aioseo.com -->\n\t<meta name=\"description\" content=\"Have a question about our practice or want to schedule an appointment?\" \/>\n\t<meta name=\"robots\" content=\"max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n\t<link rel=\"canonical\" href=\"https:\/\/www.toplinemd.com\/my-gyn-care\/patient-forms\/\" \/>\n\t<meta name=\"generator\" content=\"All in One SEO (AIOSEO) 5.0.1.1\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"My GYN Care |\" 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