Beal Hubbard Ribaudo
Donnelly Lane  Thomas
     
  Patient Portal OB Information
  Patient Forms GYN Information
  OB-GYN Links OB Medication List


Medication Record

To ensure we have a current list of all medications you are taking, prescription and non-prescription. You may download this form, fill it out and bring it to your next appointment. *Remember to list allergies to medications, allergic reactions to contrast dye, adhesive/tape, peanuts, shellfish, eggs, iodine, etc. If youa re unsure, write it down and ask the nurse or physician when you come in for your appointment.

Dexa Patient Risk Assessment

If you are scheduled for a Dexa scan in our office, please print, complete this form and bring it with you on the day of your Dexa appointment. This is a medical test and must be ordered by one of our physicians. If you believe you need one, please discuss it with your doctor, he or she will determine if this test is right for you.

Medical Records Release FROM Tulsa OB-GYN Associates, Inc.

If you are requesting Tulsa Ob-Gyn Associates, Inc. to SEND your medical records to another physician/facility, please download and complete this form.  Remember to sign and date the release. You may mail to our office or fax to 918-749-7806. Upon receipt your request will be processed within 72 hours.

Medical Records Release TO Tulsa OB-GYN Associates, Inc.

If you are requesting Tulsa Ob-Gyn Associates, Inc. to RECEIVE your medical records from another physician/facility, please download and complete this form. Remember to sign and date the release. You may mail or fax to your previous physician's office/facility.

Mirena Benefit Verification

If you and your doctor have discussed the Mirena and you are ready to order, download and complete this form. Mail the completed form back to our office or fax to 918/746.2252. Our business office will gather insurance benefits and contact you in 10-14 days with your copayment information.

Paragard Benefit Verification

If you and your doctor have discussed the Paragard and you are ready to order, download and complete this form. Mail the completed form back to our office or fax to 918/746.2252. Our business office will gather insurance benefits and contact you in 10-14 days with your copayment information.

Urodynamics Test Pack for Patient

If you are scheduled for Urodynamics testing in our office, please download and fill out all forms in this questionnaire. You will need to bring the completed forms on the day of your scheduled Urodynamics Testing.