Resources for your visit with LPWC
Welcome to our practice! As you know, Lakeland Premier Women's Clinic offers a full range of obstetric and gynecological services.
IMPORTANT: If you are experiencing any flu-like symptoms, please call (601) 939-1600 to reschedule your appointment.
Download Patient Forms
It is our goal to provide you with the best possible experience by maximizing the quality of care you receive while minimizing your wait time in the office. Our Patient forms are available for your convenience.
You must have Adobe Reader installed on your computer to view and print these forms. Download the latest Adobe Reader for free at get.adobe.com/reader.
Please bring the completed forms along with your insurance card to your first visit.
New Patient Forms
- Patient Registration Form
- Authorization for Release of Medical Information
- Financial Policy & Patient Responsibility
- Patient Medical History Form
f you are not able to complete the forms prior to this visit, please arrive at least 15 minutes early so that you may have ample time to complete any necessary paperwork.
We extend a fifteen (15) minute "grace period" to all of our scheduled patients. Please be mindful that your appointment may be cancelled if you are more than 15 minutes late. It is always best to call first to notify someone of your late arrival and to make sure that you can still be seen.
If you need to cancel or reschedule an appointment you must do so at least 24 hours prior to your scheduled visit. There is a $25.00 charge for not giving a 24-hour notice and for no-shows.
Our practice generally runs on schedule. However, please be mindful that obstetricians often have emergencies that require immediate attention. You will be promptly notified if your appointment will be affected and we will do our best to minimize any inconvenience to you.
Again, we welcome you to Lakeland Premier Women's Clinic and look forward to seeing you soon! If you have any questions, please contact our office at (601) 939-1600.