Join Our Mailing List Read Blog Facebook Twitter YouTube
Patient Information

Making an Appointment

If you would like to request a complimentary consultation then please go to the Contact Page.

If you have already made an appointment, congratulations on taking the first step in improving the quality of your pelvic, intimate and/or aesthetic health!  We are pleased that you have chosen ASC to evaluate your condition.

To facilitate your visit and ensure that ASC will be able to help you, we ask that you complete the documents below within 48 hours of making your appointment. These forms are necessary to confirm your appointment. You may choose to return the information electronically, by fax or mail. Dr. Aguirre will personally review this information to make sure that he has everything necessary to provide a comprehensive consultation on the day of your visit. Click on the below links to download PDFs of the forms.

Patient Information Form

New Patient Questionnaire

Authorization to Receive Medical Records

Please print the following forms, complete them, and bring them with you at the time of your appointment. If you have questions or concerns after reviewing our policies please do not hesitate to call our business office to discuss prior to your appointment. There is limited time on the day of your appointment to go over any concerns regarding our policies. Additionally, our business personnel may not be available at the time of your appointment. If you arrive 15 minutes late or if your forms aren’t completed and signed, your appointment will have to be rescheduled. Click on the below links to download PDFs of the forms.

Payment Terms and Agreements

Credit Card Consent
   
At your initial appointment, your medical history will be taken followed by a detailed pelvic examination. This will determine the need for diagnostic testing which will be scheduled accordingly.   

Please be advised that our staff is unable to supervise children so we respectfully request that you make prior arrangements.
   
Again, please do not hesitate to call our office with any questions or concerns you may have regarding your appointment. We look forward to meeting you.

Sincerely,
Dr. Aguirre and the ASC team

Sign up for our email newsletter


* Required Fields | Privacy Policy