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Holy Redeemer

Medical Office Building
1650 Huntingdon Pike, Suite 112
Meadowbrook, PA 19046

Hours
Monday - Friday*  9:00am – 5:00pm

* Some evening hours are available. Please call for availability.

PATIENT FORMS


Welcome to Holy Redeemer Natural Women’s Health. In order to make your first appointment go as quickly and smoothly as possible, please print and complete the following forms and bring them to your appointment along with your insurance card, copay and a photo ID, plus your medical records if available. If you’re a new patient, please arrive 10-15 minutes before your scheduled appointment time.

 

PDF TX-65Patient Information

 

PDF TX-65Authorization to Speak to Another Regarding Medical Care

 

PDF TX-65Consent for Financial Responsibility

 

PDF TX-65General Consent to Treatment

 

PDF TX-65Authorization for Access or Release of Protected Health Information

  

Payment/copay is expected at the time of your appointment. We accept cash, check, VISA, MasterCard, American Express and Discover.


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icon-online

eCare Patient Portal

Get Directions


Holy Redeemer

Medical Office Building
1650 Huntingdon Pike, Suite 112
Meadowbrook, PA 19046

Hours
Monday - Friday*  9:00am – 5:00pm

* Some evening hours are available. Please call for availability.