Patient forms

From this page you may download the forms I will need to have you fill out.

As a healthcare provider, I find it essential to know as much as I can about my patients, so that I can treat you in a holistic fashion. I will be taking into consideration aspects of your life and health that you may or may not realize are related to your gynecological wellbeing. As such, these form are extremely comprehensive and detailed.

Please be as thorough as you can, so that I can have all the tools I need in order to give you the best care possible. Thanks in advance! -JE

There are three ways in which you can complete these forms, choose your favorite.

  1. Digitally: download the forms to your desktop, fill them in, save them with YOUR NAME in the title, and email to the office:
  2. Download, then print these forms at home, fill them in and bring them to the office when you come for your visit.
  3. Come half an hour early for your visit and fill in the forms in the office.


Registration Form — for new patients only

Medical Herstory Form — for new patients only

Annual Visit Form — for returning patients only

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