Small Miracles Every Day
Main Telephone 1 (858) 455-7520 | Contact Information

Online Forms

Online Forms

Download forms below.

The following is a list of IGO Medical Group forms available online. These forms can be printed and completed at your convenience in advance of your appointment.

Forms are also available below for medical records requests. These requests can be faxed to our office, as indicated on the form.


First Time Patient

OB Waiting Room

Please fill out all of these forms and bring them into the office when you come for your appointment. Information about IGO with a map is also available.

New Patient Registration Form
New Patient Medical History Form
HIPAA Form
Patient Acceptance of Financial Responsibility Form
New Patient Information on IGO
New Patient Payment Policies Summary
Notice of Privacy Practices

New patient appointments are scheduled for an extended period of time so our physicians have a chance to get to know and understand our patient’s concerns. As insurance payments shrink and administrative costs rise, we need to make the most of our office time. This is very difficult if a new patient cancels at the last minute or does not show for their appointment.

If you decide not to keep your appointment with an IGO physician please call at least one business day in advance so we can schedule another patient in your reserved time.


Established Patient Update

Update your Information (Name, Address or Phone Number) by completing this form. Bring it into the office or fax it to (858) 455-6816.
Click to download


HIPAA Form

Update your Health Information Privacy Information by completing this form. Bring it into the office or fax it to (858) 455-6816.
Click to download


Women’s Awareness Calendar

Complete this form to assess your hormonal status. Bring this completed form to your appointment. Your physician will review the results with you.
Click to download


Request for Release of Protected Health Information (Records from Elsewhere to be Provided to IGO)

Please fill out this form and give it to your health care providers. They will send your records to IGO.
Click to download


Request for Release of Protected Health Information (Records from IGO to be Sent Elsewhere)

Please fill out this form and bring it into the office or fax it to (858) 455-6816. We will have your requested records copied and mailed per your instructions.
Click to download