We welcome you to the Couri Center for Gynecology and Integrative Women’s Health. Thank you for choosing us! To allow us to better serve you during Covid-19, we need the following information at least 24-hours prior to your appointment.
Insurance Card (copy front/back)
INTEGRATIVE FOOD SENSITIVITY FORM:
Please complete and email forms to: firstname.lastname@example.org
It is critical we receive these forms at least 24 hours prior to your appointment time.
Print forms and fill in by hand.
- Scan completed documents and email to email@example.com.
Complete forms by filling in online as .pdf.
- Please open each form and save it on your computer, preferably add your last name to the file name while saving.
- Open the saved documents and complete each fill-in form.
- Save completed documents.
- Email completed documents as attachments to: firstname.lastname@example.org
Unless canceled at least 24 hours in advance, our policy is to charge for missed appointments at the rate of $40. Please help us serve you better by keeping scheduled appointments.