ANNUAL PAPERWORK ATTACHED
IMPORTANT – PLEASE READ

Thank you for making an appointment with us! We realize that you have choices for your obstetrical and gynecological care and are pleased that you have made Obstetrics & Gynecology Associates of Hampton your choice for your medical care.

We would like to make this office visit as informative and comfortable as possible. If you have any questions or concerns you would like addressed, please write them down and bring the questions with you to your scheduled appointment. Should you so desire, spouses or family members are welcome to accompany you on your visit. However, due to limited seating, we request that no more than 1 visitor accompany you. If you find it necessary to bring your children, for their safety, please bring another adult to supervise them during the examination, as our staff cannot be responsible for them.

We value you as our patient and make every effort to respect your time. Therefore, it is necessary that you complete the attached paperwork and bring it with you to your scheduled appointment. Completing the paperwork prior to your arrival at our office allows our schedules to run smoothly, and decreases wait times for everyone. Due to the length of time required to complete paperwork, including medical history, your appointment will be rescheduled if the paperwork is not completed prior to your scheduled appointment. As your medical history and personal information can change a great deal in one year’s time, this paperwork must be completed annually so that our physicians can be aware of your current health status. Updated information also ensures that we are able to file your medical claims smoothly and accurately. Therefore, both new patients and returning patients must complete these forms and bring them to the appointment—PLEASE DO NOT MAIL THESE FORMS BACK TO US. Postal delays or lost mail may result in our not receiving your forms, and in your appointment being rescheduled.

If you have previous pertinent medical records, and your referring physician is not sending us a copy of your records, we request that you drop any records off at our office before your scheduled appointment, so that the physician has an opportunity to review them. You may also ask your referring physician to fax us your records at 722-7404. We also request that you bring all prescription bottles with you to your appointment.

We look forward to meeting your needs and making your visit with us a pleasant experience. Please contact us if you have any questions or concerns.

NO-SHOW POLICY

If, for any reason, you are unable to keep your appointment, please call our office to reschedule or cancel at least 24 hours in advance, so that someone else may benefit from the appointment slot. The practice often has to turn new patients away because we just cannot see everyone. When a patient does not call and reschedule, it prevents another patient from benefitting from that time slot.

Because of the high numbers of no-shows, we have found it necessary to implement the following policy:

Failure to call to cancel a new patient appointment will result in a $60.00 charge to your account.

Failure to cancel an established patient appointment will result in a $30.00 charge to your account.

These fees are not covered by any medical insurance.

Additionally, if a patient misses three (3) appointments without calling to reschedule or cancel we will not offer any additional appointments to the patient. The patient’s care will be transferred to another practice. We will ensure that this transfer is accomplished with no disruption to ongoing treatment.

When you call to reschedule or cancel your appointment, you will be given a cancellation code number as confirmation that your appointment was cancelled. Please keep this number for your records; it will ensure that you are not charged for a cancelled appointment.

If you have any questions or concerns about this policy, please do not hesitate to contact us.