Pink Womens Center
In order to make your visit to our office as pleasant as possible while providing you with the highest quality of care, we have implemented the following financial policies:
*Insurance information will be requested at the time of scheduling your appointment. This is to ensure that benefits will be verified prior to your visit.
*Co-payments will be collected at the time of your visit as well as any outstanding balances.

*All obstetrical patients will receive a packet containing documents explaining maternity benefits and payment information.

*Remember - Whether you are covered by medical insurance or are self-pay, you are ultimately responsible for payment of your charges.
*We accept cash, checks, Visa, Mastercard, Discover & American Express
*Please bring your insurance card and photo ID with you.
*If you have previous medical records, please bring them with you or have them mailed to our office.
*Your provider will also need a list of all your current medications.
English Forms:
Spanish Forms:
Records Request Forms:
New Patient
Annual Patient Update
Medical Records Request
New Patient
Annual Patient Update
(713) 464-1845

*Patient Name: