Patient Forms and Instructions
  • H&P Registration Forms Kit
    (Includes all registration forms --
    please be patient while it downloads)

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  • H&P Registration Forms Kit - Aesthetic Only
    (Includes all registration forms --
    please be patient while it downloads)

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  • Progress Notes

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  • Pelvic Pain & Urinary Frequency Scale

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  • Pain Diary Instructions

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  • Pain Diary at Relief Insite

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  • Quality of Life - Urinary Distress Inventory

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  • Intake & Voiding Diary

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  • Bladder Study Instructions

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  • Bladder Study Worksheet

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  • Patient Information Guide to Urodynamics

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  • Potassium Sensitivity Test

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  • Dietary Guidelines for Interstitial Cystitis

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  • Procedure Consent Form

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  • Surgical Informed Consent – Detailed

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  • Photo and Video Consent Form

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  • Pre-Op Instructions

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  • Pre-Op Orders

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  • Pre-Op & Post-Op Notes

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  • One Day Bowel Prep

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  • Post-Op T-sling

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  • Post-Op Aesthetic Vaginal Surgery

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  • Post-Op Pelvic Surgery

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  • Post-Op Orders

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  • Post-Op Minor Surgery

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  • HIV Consent Form

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  • AVS Quote

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  • Payment Policy

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  • Payment Policy for Aesthetic Surgery

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  • Credit Card / Retainer Policy

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  • Request for Chart Copy

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  • Expert Witness Fee Schedule




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PROCEDURES



  • Vaginoplasty (vaginal rejuvenation)

  • Perineoplasty (Perineorrhaphy)

  • Labia Minora Plasty (Labial Reduction)

  • Labia Majora Plasty

  • Clitoral Hood Reduction

  • Hymenoplasty

  • Laser Resurfacing

  • Incontinence Sling

  • Cystocele Repair (Bladder Repair)

  • Rectocele/Enterocele Repair (Rectal Repair)

  • Vaginal Vault Suspension

  • Uterine Suspension

  • Vaginal Hysterectomy

  • Laparoscopic Hysterectomy

  • Endometrial Ablation

  • Essure Sterilization

  • PelleveTM