Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
"Dr. Bernell is thorough, easy to talk to, knowledgeable, down to earth, and has a wonderful calming presence! She was able to help me through my labor much better than the hospital nurse! She was calm & soothing — which was much needed! I really enjoyed my pregnancy journey with her as my OBGYN! I am so happy to have her as my doctor!"
"I thought the office staff was very helpful and nice."
"This is a fantastic clinic! The staff is warm and friendly, and Dr. Bernell is an outstanding physician!"
"This place is awesome! Everyone is so welcoming and friendly! They always get you in and out very quick! I have never been more satisfied with my doctor or staff! I would highly recommend this office to anyone!"
"Dr. Bernell is thorough, easy to talk to, knowledgeable, down to earth, and has a wonderful calming presence! She was able to help me through my labor much better than the hospital nurse! She was calm & soothing — which was much needed! I really enjoyed my pregnancy journey with her as my OBGYN! I am so happy to have her as my doctor!"
"I've been with Dr. Bernell since 1997 and I have nothing bad to say about her or her staff. I've had a baby with her and two different surgeries. She has always been a wonderful OBGYN. I have sent many patients to her and they have all had positive experiences."
"I thought the office staff was very helpful and nice."
Patient Forms
Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente
Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Office Policies
Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)
Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)