Thank you for choosing Van Dyke Gynecology for your healthcare needs. To ensure you are seen in a timely manner, please complete the paperwork under the "forms" tab to the right. You will need to bring your photo id, insurance card and previous medical records and reports if indicated. Please be prepared to pay your co-payment, non-satisfied deductibles, and or co-insurance at the time of your visit.

FAILURE TO PROVIDE THE ABOVE COMPLETED INFORMATION UPON ARRIVAL WILL RESULT IN YOUR APPOINTMENT BEING RESCHEDULED.

Please arrive 30 minutes prior to your scheduled appointment with all completed paperwork. Failure to arrive with completed paperwork will result in reschduling your appointment. You may also fax this information to 407-316-9997.

If your insurance requires prior authorization for your visit (ie: PPO, HMO) it is your responsiblity to provide the authorization at the time of the visit. If prior authorization is not obtained you may be responsible for higher out of pocket charges.