Before Your Visit

Everything you need to be prepared for your first visit

Patient Access Appointment and Forms

POLICIES AND PROCEDURES

PAYMENT & INSURANCE
Payment for services or co-pays are due at the time of the appointment. Most major insurance plans are accepted. Be sure to check with us to ensure that our doctors are part of your insurance provider’s network. Please note that we are considered a medical specialty, and as such, you must obtain the necessary referrals from your primary care physician in advance of a first appointment with us.

RESCHEDULING
We know your time is precious, but at the same time, we like to give all of our patients high quality medical care. If emergencies, deliveries or unforeseen circumstances arise during patient appointments to delay us more than 30 minutes, we will inform you and offer you the opportunity to reschedule. If you are unable to keep your appointment, please call us to cancel as soon as possible. You will be billed a no-show fee for any appointment that you miss without prior cancellation at least 24 hours in advance.

MINOR CONSENT
Please note that if you are a minor or have a minor dependent, it is required by law in the state of Florida to have the written consent of a parent or legal guardian, that must sign in person in the office at every visit, in order for the minor to receive any diagnostic, medical, and/or surgical treatment by qualified licensed health care providers. The Woman’s Group adheres to the exemptions set forth in Florida Statutes, Sections 743.065 and 384.30, pertaining to the valid consent of a minor to receive medical or surgical care or services relating to pregnancy, sexually transmitted diseases, or any other conditions when allowed by statute. We apologize for any inconvenience that this creates.

FORMS

NEW PATIENTS:

If you’re a first time patient, we’d like to help speed you through your initial appointment with us. Take a moment to print and complete the following forms. The first option listed, the New Patient Packet, has all the forms combined into one document for your convenience to print together. Alternatively, you may choose to print forms individually. There are only two forms that don’t require signatures or to be filled out. The Binding Arbitration form and the Notice Of Privacy Practices forms may be read online without being printed for those conserving ink and paper.

Be sure to bring all signature forms with you to your appointment.

If you are a minor or have a minor dependent, please read our policy regarding Minor Consent.

New Patient Packet, Complete (18 pages) >>Download Form Now
“Welcome” To Our New Patients (1 page) >>Download Form Now
Binding Arbitration, English & Spanish (2 pages) >>Download Form Now
Notice of Privacy Practices (6 pages) >>Download Form Now
Receipt of Notice of Privacy Practices (1 page) >>Download Form Now
Patient Information (1 page) >>Download Form Now
Financial Agreement (1 page) >>Download Form Now
Health History Questionnaire in English (2 pages) >>Download Form Now
Health History Questionnaire in Spanish (2 pages) >>Download Form Now
Auth for Request of Medical Records (1 page) >>Download Form Now
Auth to Release Medical Records (1 page) >>Download Form Now

Patients who wish to watch and listen to Binding Arbitration details in a video may find them in English and Spanish on the ‘Binding Arbitration’ tab at the top of this page.

EXISTING PATIENTS:

From time to time, you may require for us to release a copy of your records to another medical institution. To do so, you must fill out a Medical Release form.

Medical Release Request >>Download Form Now

WEIGHT LOSS PATIENTS:

Those patients joining our Weight Loss program will need to fill out a number of forms prior to their first visit.

Diet and Exercise History >>Download Form Now
Patient Release >>Download Form Now

Please find Binding Arbitration videos and forms in both English and Spanish below.

Download English Binding Arbitration Form

Binding Arbitration Video in English – Press Play to Watch

Download Spanish Binding Arbitration Form

Binding Arbitration Video in Spanish – Press Play to Watch

INSURANCE PLANS NOT ACCEPTED

We accept most major insurance plans with the exception of a few specific plans listed here.

For a larger text view of the insurance plans we do not accept, please click on the imageInsurance Plans Not Accepted at TWG

LAB RESULTS

Are you receiving lab results before TWG has contacted you??

The 21st Century Cures Act is a comprehensive federal law that, among other things, imposes new rules about health information.  Due to this law, 3rd party labs (like Quest and LabCorp) and imaging facilities (like BayCare and Tower) have to legally make all test results digitally available to the patient immediately after available.  This means that you may see these results before your provider sees them.  This law allows our patients increased access to their health information and TWG supports this access as it allows you to become more engaged in your care. We understand this can create confusion, concern, and frustration for our patients.  The Woman’s Group will make every effort to review your results and provide a medical interpretation, including any important information and treatment recommendations, in a reasonable amount of time.  Please allow us adequate time to review and interpret your results, and you will hear from our office (either via the patient portal or phone call) as soon as we get done with our review.  Also, please know that all labs marked in red or “abnormal” may not be medically significant, so do not alarm.  We will help you interpret these results.  We appreciate your patience in allowing us time to thoroughly review your results.  We encourage you to make a telemedicine appointment if you would like to review your results directly with your provider.