Patient Materials
Before coming to our office for your appointment, please print and fill out the forms below. By filling them out beforehand, you can give us complete, accurate information that we will need in order to properly address your concerns. This will reduce the amount of time you spend in the waiting room, allowing us to devote more time to treating and caring for you.
We request that you fill these forms out as thoroughly as possible. However, please leave blank any fields that say "office use only" underneath ("Medical Record Number" for example).
- New Patient Registration(PDF, 1 page, 154KB)
- Gynecological History Form(PDF, 1 page, 176KB)
You will need Adobe Reader to view these files. You can download the Adobe Reader here.
If you are interested in learning more about your health care options before coming in for your appointment, below are some resources for information about important gynecological and obstetrical issues.
Breast Self-Exam
- How to Examine your Breast(PDF, 1 page, 732KB)
Birth Control
- Depo-Provera(PDF, 2 pages, 1,187KB)
- The Pill(PDF, 3 pages, 1,066KB)
- The Patch(PDF, 2 pages, 1,805KB)
- The Ring(PDF, 2 pages, 893KB)
STDs and STIs
- Chlamydial Infection in Women(PDF, 2 pages, 1,373KB)
- Understanding Genital Herpes(PDF, 4 pages, 4,045KB)
Other Conditions
- Urinary Tract Infection (UTI)(PDF, 1 page, 160KB)
- Instructions for the one hour glucose test(PDF, 1 page, 113KB)
Human Papillomavirus (HPV) Vaccine
- Patient Information about Gardasil(PDF, 1 page, 221KB)
Surgical Procedures
- Colposcopy of the Vagina and Cervix(PDF, 3 pages, 848KB)
- LEEP(PDF, 3 pages, 1,800KB)
- Dilatation and Curettage (D & C)(PDF, 2 pages, 1,952KB)
- Myomectomy (Fibroid Removal)(PDF, 4 pages, 2,430KB)
- Meet the DoctorDr. Rodriguez is affiliated with the Association of Read More
- Patient MaterialsBefore coming to our office for your appointment, please print and fill out the forms below Read More
- Insurance We accept all major medical insurances Read More