Getting Ready for Your Visit

Complete Your Forms

Before your appointment with us, quickly and conveniently access patient forms from our practice. Receiving your most up-to-date health information helps us prepare for your visit. We are pleased to now offer you the opportunity to complete your forms securely online at least 72 business hours prior to your visit or your appointment(s) will be cancelled.

If you are a new patient or an established patient who has not visited our office within the past three years, it is imperative that we receive updated demographic, insurance, and medical information forms at the time of your visit.  Your most current insurance card must be presented at the time of the visit. It is also important that you review our Administrative Policies.

ONLINE PATIENT FORMS


Click on the link that describes your appointment type. Please do not complete forms for two different appointment types. Effective 10/4/21, forms must be completed at least 72 business hours prior to your scheduled visit or your appointment(s) will be cancelled.

DOWNLOAD PATIENT FORMS


To view the forms listed below, you will need Adobe Reader. Please download and print one set of forms only. Click on the link that describes your appointment type. Please do not complete forms for two different appointment types. Effective 10/4/21, forms must be completed and faxed to our preregistration department at (667) 204-7241 at least 72 business hours prior to your visit or your appointment(s) will be cancelled.

New GYN Patient Packet 

If you are being referred to us by another physician, please bring your referral form, if applicable, and any lab results that are relative to your visit with us. Be prepared to give us the name, address and phone number of your primary care physician.

New Prenatal Packet (New to our practice, have not been seen in over three years, or new pregnancy)

We will need to register your care with your insurance company, so please remember to fax your forms, as well as a copy of your insurance card at least 72 business hours prior to your initial visit or your appointment(s) will be cancelled. Please make every effort to obtain a copy of your prior records before your visit.  A copy of our record request form can be found at the bottom of this page.

We will need your prenatal records before we can make you an appointment for your initial visit with our practice.   Please complete the New Patient OB Transfer Checklist along with the Consent to Release Medical Records to Luminis Health OB-GYN – Annapolis form, and forward those to your previous OB-GYN. Once we receive your records we can begin your pre-registration process.

Records Request Form

In an effort for our providers to have your complete medical history at your visit, we ask that you obtain these records from your prior physician’s office. Please download, print, and complete the form below to obtain your records from your previous healthcare provider.

If you would like a copy of those records, please have records sent directly to you so you can make a copy for yourself, prior to bringing them to our office. Once we receive your records, we will not return them to you. There is a place on the form to check ‘send records to patient’. Keep in mind that some offices take up to one month to process your request for records. Records should be mailed to Luminis Health OB-GYN – Annapolis office or hand-carried to your appointment.

If you would like a copy of your records from our practice, please print, complete and fax the following form.

Call Us (410) 573-9530