For the health and safety of our patients and staff we will be implementing the following actions at our clinics:  Everyone with direct patient contact  will wear a mask,  additional disinfecting protocols will be followed per CDC guidelines and visitors will be limited to one support person and NO children under the age of 16 years old (with exception of newborns) . We are now offering TELEHEALTH appointments face-to-face, video appointments with providers. Please call us to determine if this is a good option to meet your needs. In addition, all WCNC classes will resume in a hybrid format beginning on April 3, please see individual class descriptions for details. Support groups are currently suspended at all locations until April 17th.
Note that our Greeley office will be open on Tuesday’s from 8-5 through May 1, 2020.
Please see FAQ’s and News for additional information including TELEHEALTH instructions.

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Patient Forms

Patient Forms at WCNC

Patients can print and fill out their forms or arrive 20 minutes prior to their appointment time.

If you are a new GYN patient please complete interactive form, print and bring to your appointment. New GYN Patient Forms. If you are a new patient coming for an annual exam, breast problem or ovarian problem, AND are age 25 or greater you will need to fill out the Family History Questionnaire in addition to the New Patient Forms.

New GYN Patients:

Newly Pregnant Patients:

Postpartum Patients:

Mammography patients:


If you are requesting that your medical record be sent to or from a referring provider: