Forms – Fair Oaks Women’s Health

Forms

Forms: All Patients

Welcome Letter

FOWH is affiliated with Huntington Hospital/Cedars-Sinai

FOWH is part of the Huntington Hospital-Cedars-Sinai Healthcare system. We are still the same doctors and staff in the same location providing the same Ob/Gyn medical care that you trust. But there are some changes:

Bills and statements will come from Cedars-Sinai. If you have any questions regarding your Cedars-Sinai bill, please call Cedars Patient and Financial Services at 866-803-1777.
Our forms have changed. Some are new and some are modified.
Our office workflow, systems, hardware and software are being upgraded.

We apologize for any inconveniences or disruptions that might arise from our new affiliation. Please share your concerns with us at any time. Call (626) 304-2626 and ask for the Office Manager.

Click here for pdf copy of this letter

Ob and Gyn Forms Packets

These are packets of our forms. Print One-Sided.

Bill of Rights

Cedar-Sinai Patient Bill of Rights.

Records Request

Use this form to request records, either for another provider to send to us, or for us to send to another provider or a copy for yourself.

Being Referred Handout

If you are being referred to a specialist, here is some useful advice.

California State Disability (SDI)

This form is used to apply for California State Disability (SDI) benefits. DO NOT submit this form until you have STOPPED working. Then fill out your portion including the last day that you worked. After that, give us the form (or send it) and we will complete it and file it for you.
Tutorial for online EDD claims

HIPAA Privacy Notice

HIPAA Privacy Notice

Forms: Obstetrics Patients

Obstetrics Forms Packet

Use this packet to print out all our OB forms at once (updated July 2024).

Print One-Sided.

Pregnancy Checklist Form

This is also at the back of the OB Guidebook. We provide it here as a one-page handout.

FOWH OB GUIDE

Download a PDF version of our complete Pregnancy Guide, updated June 2024.

Labor and Delivery (L&D) Registration Form

FAMILY BIRTH CENTER REGISTRATION

Birth Plan (Huntington Hospital)

Here is the Hospital Birth Plan, called the Birth Partnership form.

For Scheduled C-section Patients

This is a “letter” written to you, our scheduled C/S patient, describing the events before, during and after your “Big day” !

FOWH Library

Here is a list of downloadable forms for OB patients. This includes CA State Disability Information, FOWH OB information, Huntington Hospital forms, and more.

Prescription for Breast Pump

Three forms are provided. One is for a standard breast pump, to be provided by your Health Insurance Provider. The other two are for a HYGEIA model pump, a hospital-grade pump we believe to be a good model.

Postpartum Depression Quiz

Click here for our Postpartum Depression Quiz – If your score is > 10, please call our office.

Great Book – “Your Pregnancy and Childbirth”

Book: Your Pregnancy and Childbirth

Based on ACOG guidelines and written by the experts in women’s health care, this new 7th edition of Your Pregnancy and Childbirth: Month to Month (2021) gives your patients the most accurate information available about pregnancy, childbirth, labor and delivery, breastfeeding, and the postpartum period.

Forms: Gynecology Patients

Gyn Forms Packet – NEW GYN PATIENTS

NEW GYN PATIENTS: Use this packet to print out all our Gyn forms at once.

Print One Sided. For NEW GYN patients.

Gyn Forms Packet – RETURN GYN PATIENTS

RETURN GYN WW PATIENTS: Use this packet to print out the forms.

Print One Sided.