Adriatica Women's Health OB-Gyn
About Adriatica Women's Health OB-Gyn
About Adriatica Women’s Health: Experience Meets Commitment, Compassion and Excellence
Adriatica Women’s Health is a reputable, well-established OB/GYN practice committed to partnering with women for their best health and highest quality of life… through every stage of life.
For nearly two decades, AWH has focused on providing the highest-standard, most complete care for every type of problem or concern affecting the health of women. Today, we have a reputation for excellence — from compassion and understanding to impeccable service to state-of-the-art care and top-quality treatment outcomes.
OUR MISSION: To provide the best medical care to women by working as a team, striving to be our patients’ valued healthcare partners, delivering superior service and providing state-of-the-art OB/GYN care to promote healthy, happy families.
Insurance Information
Contact office for insurance information.
Patient Forms & Documents
At Adriatica Women’s Health (AWH), we strive to make every visit productive and efficient. Plus, we’re dedicated to making sure you’re informed, up-to-date, prepared and empowered. With that in mind, we’ve created this clearinghouse of downloadable forms and documents for your convenience and highest-quality care.
New-Patient Paperwork
- Demographics Sheet
- Financial/Office Policies
- Notice of Privacy (HIPAA) Practices
- HIPAA Consent Form
- Patient Intake History
- New Patient Packet – Annual Appointment
- New Patient Packet – Problem Appointment
- New Patient Packet – Prenatal Appointment
Established-Patient Annual Paperwork
- Interval Gynecological History
- Demographics Sheet
- Financial/Office Policies
- Notice of Privacy (HIPAA) Practices
- HIPAA Consent Form
Pregnancy Paperwork
- Prenatal Genetic Screen
- Preparing For Pregnancy
- Dental Treatment Letter
- Adriatica Anesthetics Dental Letter
Authorizations
Medical Records
Patient Instructions for Medical Record Requests
Effective October 30th, 2023, Adriatica Women’s Health has partnered with HealthMark Group to ensure the accurate and timely completion of medical record requests.
How?
Requests should be submitted electronically to HealthMark’s Request Manager at https://requestmanager.healthmark-group.com. Once logged in, select “Submit Request” from the menu options and enter all required fields to provide an authorization directly to HealthMark. Your medical record request will be processed, and a notification will be sent via mail or email once complete and available for download.
Any questions?
Please log in to the Request Manager linked above for status updates or to chat with support. If you have any questions, you may contact HealthMark at 800-659-4035 or status@healthmark-group.com.
For urgent requests (needed within the next 24 hours) please contact the office directly or submit the form below directly to the office:
- Records Release Form – to request your previous records be sent to Adriatica Women’s Health please fax this form to your previous medical provider for processing.
- Records Request Form -to request a copy of your Adriatica Women’s health records.
Patient Instructions for FMLA/Disability Requests
Adriatica Womens Health has partnered with HealthMark Group to ensure the accurate and timely completion of your FMLA and/or Disability forms.
How?
Requests may be submitted electronically to HealthMark’s Request Manager at https://requestmanager.
If an email is provided, you will receive a response directly from HealthMark notifying you of the prepayment invoice. After payment, the completed forms may be downloaded directly through HealthMark’s website, or provided directly to you through an agreed to delivery method (i.e. secure email, mail, etc.).
Any questions?
Please log in to Request Manager for status updates or to chat with support. If you have any questions, you may contact HealthMark at 972-895-2138 or email fmla@healthmark-group.com.
Patient Survey
Surgery Guide
Notices
About Adriatica Women’s Health: Experience Meets Commitment, Compassion and Excellence
Adriatica Women’s Health is a reputable, well-established OB/GYN practice committed to partnering with women for their best health and highest quality of life… through every stage of life.
For nearly two decades, AWH has focused on providing the highest-standard, most complete care for every type of problem or concern affecting the health of women. Today, we have a reputation for excellence — from compassion and understanding to impeccable service to state-of-the-art care and top-quality treatment outcomes.
OUR MISSION: To provide the best medical care to women by working as a team, striving to be our patients’ valued healthcare partners, delivering superior service and providing state-of-the-art OB/GYN care to promote healthy, happy families.
Contact office for insurance information.
At Adriatica Women’s Health (AWH), we strive to make every visit productive and efficient. Plus, we’re dedicated to making sure you’re informed, up-to-date, prepared and empowered. With that in mind, we’ve created this clearinghouse of downloadable forms and documents for your convenience and highest-quality care.
New-Patient Paperwork
- Demographics Sheet
- Financial/Office Policies
- Notice of Privacy (HIPAA) Practices
- HIPAA Consent Form
- Patient Intake History
- New Patient Packet – Annual Appointment
- New Patient Packet – Problem Appointment
- New Patient Packet – Prenatal Appointment
Established-Patient Annual Paperwork
- Interval Gynecological History
- Demographics Sheet
- Financial/Office Policies
- Notice of Privacy (HIPAA) Practices
- HIPAA Consent Form
Pregnancy Paperwork
- Prenatal Genetic Screen
- Preparing For Pregnancy
- Dental Treatment Letter
- Adriatica Anesthetics Dental Letter
Authorizations
Patient Instructions for Medical Record Requests
Effective October 30th, 2023, Adriatica Women’s Health has partnered with HealthMark Group to ensure the accurate and timely completion of medical record requests.
How?
Requests should be submitted electronically to HealthMark’s Request Manager at https://requestmanager.healthmark-group.com. Once logged in, select “Submit Request” from the menu options and enter all required fields to provide an authorization directly to HealthMark. Your medical record request will be processed, and a notification will be sent via mail or email once complete and available for download.
Any questions?
Please log in to the Request Manager linked above for status updates or to chat with support. If you have any questions, you may contact HealthMark at 800-659-4035 or status@healthmark-group.com.
For urgent requests (needed within the next 24 hours) please contact the office directly or submit the form below directly to the office:
- Records Release Form – to request your previous records be sent to Adriatica Women’s Health please fax this form to your previous medical provider for processing.
- Records Request Form -to request a copy of your Adriatica Women’s health records.
Patient Instructions for FMLA/Disability Requests
Adriatica Womens Health has partnered with HealthMark Group to ensure the accurate and timely completion of your FMLA and/or Disability forms.
How?
Requests may be submitted electronically to HealthMark’s Request Manager at https://requestmanager.
If an email is provided, you will receive a response directly from HealthMark notifying you of the prepayment invoice. After payment, the completed forms may be downloaded directly through HealthMark’s website, or provided directly to you through an agreed to delivery method (i.e. secure email, mail, etc.).
Any questions?
Please log in to Request Manager for status updates or to chat with support. If you have any questions, you may contact HealthMark at 972-895-2138 or email fmla@healthmark-group.com.
Patient Survey
Surgery Guide
Notices