Central Office: 
800 SW Lincoln St., Topeka, Kansas 66606
785-233-5101
Mission Woods: 
2830 SW Urish Rd., Topeka, Kansas 66614
785-273-4010

Patient Forms

Documents in PDF format

The documents on this web page are provided in Adobe Portable Document Format (.pdf). In order to view or print these documents, you will need to download and install the free Adobe Acrobat Reader software (click here to download Adobe Reader).

Authorization to Release Protected Health Information

New Obstetric Patient Welcome Packet

New Gynecology Patient Welcome Packet

Notice of Privacy Practices

Request by Patient for Access to Protected Health Information

Central Office

800 SW Lincoln St
Topeka, Kansas 66606
785-233-5101
785-233-1404 - FAX

Mission Woods Office

2830 SW Urish Rd

Topeka, Kansas 66614

785-273-4010

785-273-8530 - FAX

Office Hours

8:00 a.m. - 5:00 p.m. Monday - Friday
24-hours answering service available.

Did you Know?

Infertility affects 7.3 million people in the U.S. This figure represents 12% of women of childbearing age, or 1 in 8 couples. Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained.

This site is for informational purposes only and is not intended to provide medical advice. Please seek advice from a health care professional for any serious medical condition.

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