Forms

To set up an initial consultation, call 415-922-9122 to speak to one of our experienced front office staff or email us at  [email protected].

Intake Forms for New Patients:

1. New Patient Forms – This includes Baywell’s Notice of Privacy Practices which informs you of your rights to protect your personal health information
2. Authorization for Release of Information – to authorize your doctor to collaborate with you treatment team and provide you with the best medical care

Forms for Existing Patients:

1. Baywell Credit Card Information Form – kept securely on file for all Baywell patients
2. Medical Records Release Form – in case you need to request a copy of your medical record