Consent for Labwork/Ancillary Services

As a part of your visit, specimens (pap smear, blood work, cultures, etc.) may be obtained and sent to an outside lab for diagnostic testing. You will be billed separately for this diagnostic testing by the outside lab, and you are responsible for the payment of this lab’s services in addition to your payment to Brookside Women’s Medical Center.

If you are at our office for an annual exam or experiencing pelvic pain, discharge, unexplained vaginal bleeding, bleeding after a pap smear, or fever, cultures will always be taken to test for chlamydia and gonorrhea. Untreated Chlamydia is the leading cause of infertility in this country. NOTE: Any positive results are required by state law to be reported to the Department of State Health Services.

You will be given the opportunity to discuss the results of your exam, treatment plan, and the tests that are recommended for you with the doctor or nurse practitioner during the visit.

Thank you so much for all your help. Everyone has been so friendly, supportive, and compassionate. I?m so thankful for this facility. I don?t know what I would have done without you.
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