Patient Registration Forms & Privacy Notices

Patient Registration Forms

Thank you for choosing Mountain Vista Women's Care. Prior to your first visit, please fill out the paperwork below and bring it with you on the day of your appointment. Please fill out the packet corresponding to your initial visit, either OB or GYN. Thank you.

Registration Form

History Intake Form

Patient Consent Form

Phone Consent

Patient Authorization for Release of Records

Breast Cancer Family History Screening Form

OB Questionaire

Pregnancy Risks

Privacy Notices

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Notice of Privacy Practices

Aviso Sobre Las Practicas De Privacidad

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