Making an Appointment

If you would like to request a personalized consultation, 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 and return them to our office prior to making your appointment. These forms are necessary  for Dr. Aguirre to confirm he is able to treat your condition.  You may choose to return the information by email, 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

Payment Terms and Agreements

New Patient Questionnaire

Authorization to Receive Medical Records

A copy (front and back) of your insurance card(s)

Please print the following forms, complete them, and bring them with you at the time of your appointment.

Notice Of Privacy Practices and Acknowledgement

Medication Alert

If you have questions or concerns after reviewing our policies please do not hesitate to call our business prior to your appointment, to discuss . 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 late or if your forms aren’t completed and signed, your appointment may need to be rescheduled and a cancellation fee may apply.

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