About Our Covid-19 Response: At Eastern OBGYN, we are focused on keeping you safe. All of our staff will be wearing masks during your visit and you will be provided with a mask when you arrive. We are also offering telemedicine visits as an alternative to in-clinic visits for specific health problems. Please call our office at (205) 838-3036 for more information or to schedule an appointment.
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205-838-3036
  • Our Practice
    • About Us
    • DaVinci Surgery
    • 3D and 4D Ultrasound
    • Pristina Mammography
  • Our Providers
  • Contact
    • Contact Us
    • Appointments
  • Location
  • Resources
    • Patient Portal
    • Patient Education
    • New Patient Guide
    • Patient Paperwork
    • Billing and Insurance
    • Office Policies
  • OB/Pregnancy
Image
  • Our Practice
    • About Us
    • DaVinci Surgery
    • 3D and 4D Ultrasound
    • Pristina Mammography
  • Our Providers
  • Contact
    • Contact Us
    • Appointments
  • Location
  • Resources
    • Patient Portal
    • Patient Education
    • New Patient Guide
    • Patient Paperwork
    • Billing and Insurance
    • Office Policies
  • OB/Pregnancy
205-838-3036
en_US EN
en_US EN es_MX ES de_DE DE ko_KR KO vi VI zh_CN ZH zh_HK ZH_HK

Patient Paperwork

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All Patients

All new and established patients must fill out the following forms. To save time, you may wish to print and fill them out before your appointment and bring them with you.

Registration Form
Patient Privacy FormPlease read, do not print
GYN Health QuestionnaireIf you are having a GYN appointment
OB Health QuestionnaireIf you are having a OB appointment

Medical Records


Send Your RecordsTo allow Eastern OBGYN to send your records to another physician's office
Request Your RecordsTo allow Eastern OBGYN to request your records from another physician's office

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    (205) 838-3036
    (205) 838-5832
    Send a Message
    Patient Portal
    Location

Our office at St. Vincent's East

48 Medical Park Drive East

Suite 355

Birmingham, AL 35235

    Map & Directions

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