Forms

In Preparation of Appointment:

To keep your record updated and your care provider informed, we ask that you complete any paper work we have assigned to you at least 48 hours BEFORE your appointment.

DO NOT MAIL THIS INFORMATION.

Due to social distancing guidelines, we have removed seating for you to comfortably sit and complete a lengthy history form.

Once you have downloaded or printed the paperwork here, you easily are able to upload or attach directly to your medical record from your Partners Patient Gateway Account.

We ask that you also upload a copy ( front and back ) of your most recent insurance card into the Patient Gateway Portal.

Please bring a referral if required by your specific insurance plan.

Please also review your current medication list that is located in your Patient Gateway Chart and notify us of any errors or changes. If you are new to us, please be prepared with a list of your current prescribed, over the counter ( OTC ) medications, vitamins and supplements.

Wellesley Women’s Care is affiliated with Partners Healthcare System. If you are new and coming to us from outside this network, we will not have access to your previous medical records.

• Please upload or attach to your Patient Gateway Portal, records that are relevant to your visit.
• If you are wanting to review ultrasound, MRI or any other imaging reports, DO NOT BRING films or CD’s. Upload or attach Reports only.