Forms

Click on the links below to download forms (Adobe Reader is required, get it below). Please print and complete the forms. Bring them with you to your appointment or mail them to the office at:

The Women's Clinic
135 East Claflin
Salina, Kansas 67401

PATIENT INFORMATION

INFORMATION DISCLOSURE

PATIENT ASSESSMENT

RECORDS RELEASE

The Women's Clinic provides comprehensive care for women in all stages of life. Not only do we strive to be an area leader in women's healthcare, we also want to provide you with the highest quality of health care in a comfortable, personalized, family-oriented atmosphere. Our professional staff is here to serve you.
Dr. Merle J. "Boo" Hodges
 MD, FACOG
Dr. Christopher R. Graber
MD, FACOG
Dr. Merle A. Hodges
 MD, FACOG
135 East Claflin
Salina, Kansas 67401
TEL: 785.827.7996
FAX: 785.825.4490
AFTER HOURS:
785.452.4011

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