New Patients

Pre-Appointment:

Dear New Patients, let's get to know each other better! Please be on the look out for two emails, the first from Peninsula OBGYN and the second, an invitation from MyChart to sign up for our optional online patient portal.

Online Portal:

Peninsula OBGYN Integrative offers an optional online patient portal, MyChart. It houses your appointments history, messaging (most secure method of communication - second to face-to-face) as well as your laboratory results.

Please call us at 650.542.0092 to provide your email address so that we can send an email invitation from MyChart to create your patient account.

Forms:

Please print and complete the forms below and bring them with you to your appointment. Please share your information, medical history and lifestyle information. This will help us better assist and treat you. For your convenience, Peninsula OBGYN Integrative will also email these forms to you.

Do plan on arriving 15 to 30 mins before your appointment time if you prefer to fill them out prior to your appointment.

For all New Patients:

• Patient Registration Form

• Insurance & Financial Policy

• Consent for Treatment

Print and Retain for your records:

• Notice of Health Information Privacy Practices

For Women's Health Patients- in addition to "Patient Registration Form", "Insurance & Financial Policy" & "Consent for Treatment" forms, please print and complete the following:

• GYN Questionnaire

For Acupuncture & FSM Frequency Specific Microcurrent Patients, in addition to "Patient Registration Form", "Insurance & Financial Policy" & "Consent for Treatment" forms, please print and complete the following:

• Informed consent for Acupuncture/ FSM

• Body Pain Map

• Acupuncture & FSM Form

Day of Visit:

Please bring with you

• Completed 'Patient Registration', 'Insurance & Financial Policy' and 'Consent for Treatment' forms

• Form of ID e.g. Driver's license

• Health insurance plan information including

  • • Insurance Card and Medicare Card (if applicable)

    • Authorization, Referrals, Pre-certification

• Prescription Medications and dosages

• Recent and applicable test results e.g X-ray, MRI, CAT scans, blood work, genetic tests