Patient Information Sheet


Primary

Secondary

Authorization to Communicate Information to your Voicemail

Yes, to facilitate the communication of tests results and other information; I authorize Associates in Women's Health to use my Voicemail if the physicians and staff are unable reach me directly.(Please check the phone number that you would like us to use.)

No, I do not authorize Associates in Women's Health to leave confidential information(tests results) on my Voicemail.