Your First Visit


We look forward to seeing you for your first visit.  Please have the following items completed and available when you come in.

You may print out your form and fill it out by hand then print and bring the form with you.  Due to HIPAA regulations, please do not fax any of these forms back to us.

New OB Patient Form

New OB patients are asked to complete a New OB Patient Form with complete personal and family medical history.  This will help us have a comprehensive understanding of your health during your pregnancy.

New GYN Patients Form

New GYN patients are asked to complete a New GYN Patient Form with complete personal and family medical history. Please complete this form before your first appointment.


Insurance Information

If you are a new patient, be sure to bring your insurance papers with you.  If you do not have proof of insurance, you will be billed as a self-pay patient.  For return patients, please have current proof of active insurance, as we will need that information to bill your insurance company.

Consent Forms for Minors

If you are a minor, you may need consent for certain types of treatment such as routine GYN care or surgery.  There are many types of care where a minor has the same rights as an adult.  We will be happy to clarify your situation over the phone.  Please have a parent fill out the Permission to Treat a Minor Patient Form if there is a question about the need for consent to treat.

HIPAA Notice of Privacy Practice

Please read and sign the HIPAA Notice of Privacy Practice included with your new patient forms. 



Your new patient forms request that you list all your current medications.  If your list requires more space than what is provided or you have your information typed on a separate sheet of paper, please make sure to bring it with you on your first visit.



You will need to pay your copay at the time of your visit.  You may pay by cash, check or credit card.


Driver’s License or Other Legal Picture ID

Please remember to bring your valid ID with you.


We look forward to seeing you on your first visit!

Capital Women's Care Rockville OBGYN
9711 Medical Center Drive, Suite 109
Rockville, MD 20850
Phone: 301-762-5501
Fax: (301) 309-8727
Office Hours

Get in touch