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       Locations: Exton PA and Paoli PA   »  Click for Directions
Phone: (610) 280-3636
Great Valley OB/GYN Family

Great Valley Ob/Gyn | Forms

As of 8/2017, a new electronic medical record (EMR) system was installed in the office. Unfortunately, this means that the first time we see you after that, we will need to re-enter your information. We sincerely apologize for this inconvenience and the time required. Thank you for your patience and understanding.

 

The office forms have been changed. Some of them are now available on-line and may be filled out before your appointment. These include a patient registration form and a patient financial responsibility form.

Patient Registration Form

Financial Responsiblity Form

 

Prior to your appointment in the office, you will be asked to review and sign a Notice of Privacy Practices page and a HIPAA form. There are 3 different HIPAA forms now depending on your specific circumstances – the appropriate one will be provided to you at your visit. If you wish to review the Notice of Privacy Practices beforehand, please click on the link:

Notice of Privacy Practices

 

A summary of Axia’s financial policy may be found via this link:

Financial Policies and Procedures

 

If you need to have records released either from another physician/provider to us or from our office to another physician/provider, you may access the authorization for release form here:

Authorization to Release Medical Records

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