Patient Forms


 

Prior to your appointment, complete the patient information on the patient portal located on our home page. If you do not wish to access the patient portal please arrive 15 minutes prior to your scheduled visit to complete the appropriate paperwork.

For New OB patients please print off and complete the form below and bring with you to your appointment. 

If you were referred to our clinic or are transferring to us, make sure that you either bring your old records with you or sign a record release prior to your appointment. 


What to bring to your appointment

A list of all medications, prescriptions and supplements you are currently taking.Include the dosage instructions. A list of current medical conditions, prior surgeries or medical treatment you may have had and your immediate family's medical history (parents, siblings, grandparents) Your health insurance card, including your personal and emergency contact information.


Late policy

Should you arrive for your appointment more than 15 minutes late, we will attempt to work you in but may, if necessary, reschedule your appointment.Please call 24 hours in advance of your appointment should you need to change or cancel your appointment. 

Location
Dakota Women's Clinic
625 N Foster St, Suite 108
Mitchell, SD 57301
Phone: 605-215-0824
Fax: (605) 990-1839
Office Hours

Get in touch

605-215-0824