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Stephen R. Wells, M.D., A.P.C.
a division of Women’s Health Partners of California, Inc.
Obstetrics, Gynecology, and Minimally Invasive Surgery
110 Tampico, Suite 220, Walnut Creek, CA 94598 ◊ 925-935-5356 ◊ fax: 925-935-1070 ◊ www.stephenwellsmd.com

 

Dear Patient,

Welcome to our office! Please take a few minutes to completely fill out the following forms so that we may better serve you. Be very accurate and specific and feel free to elaborate on any answers you give.

Please fill in and electronically return these forms so that we have at least two business days to input your information into your electronic medical record. We have strived to make it very easy to send these forms back to us electronically in a HIPPA compliant fashion. If you are unable to send them back electronically, please fill them out, print them, and mail them to us so that they arrive at least two business days before your appointment. If we do not receive your paperwork (either electronically or in hard copy) in advance of your appointment, your wait time in the office may be longer than usual or we may be forced to reschedule your appointment altogether, as we will need to input all of your information prior to you being seen.

Our goal is to be as efficient as possible with paperwork and we ask for your help, so that we may keep your wait time as short as possible. Thank you for working with us! We look forward to assisting you with your gynecologic or obstetric needs

Sincerely,

Stephen R. Wells, MD

Link to our Electronic Forms

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