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Patient Forms

For your convenience, Facey has made our patient registration forms available online. Please be aware that at this time these forms can not be submitted to Facey electronically. After filling out the appropriate forms, Please bring them with to your first appointment along with your insurance card and a photo ID. If any additional information is necessary, our reception staff will happily assist you. Adobe Reader® will be needed to open the forms, and can be obtained here.

*All patients must read and/or sign the Privacy documents noted by the asterisks * below.

Obstetrics & Gynocology (OB/GYN)
First Visit to the OB Office
Genetic Screening Information Sheet
Additional Resources
Prescription Refills FAQ
New Patient Welcome Packet 4.3 MB
Facey Phone Book 2.3 MB
Privacy & Information Release
Welcome New Patient
Notice of Privacy Practices *
Acknowledgement of Notice
of Privacy Practices
Amendment Request Form
Request for Confidential Verbal Communication

  • en Español
  • Restriction Request Form

  • en Español
  • Authorization to Release Medical Information

  • en Español
  • Internet Privacy Policy