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CALL TODAY: (832) 602-2030

CALL TODAY: (832) 602-2030

REQUEST AN APPOINTMENT

REQUEST AN APPOINTMENT

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    • Meet Dr. Michael D. Kelly
    • Mariana Rodriguez, MSN, APRN, FNP-C
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Request an Appointment

Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact our office at (832) 602-2030.

Once you have made an appointment, you will receive login information for our patient portal so that you can complete your health history form online. See below for additional forms to complete.

NOTE: Please understand that your online appointment is ONLY an estimation of availability. After you submit your request, our appointment scheduler will respond within 72 hours.


Patient Registration Forms

Doctors for Women in Houston, Texas welcomes you to our practice. Once you have made your initial appointment, please pre-register by completing your health historythrough our patient portal.

You may also download, print, and complete additional forms below prior to your appointment. Please be sure to bring them with you to your first visit, along with any diagnostic films or other test results that may have been ordered or performed by another physician. Completing the forms prior to your visit will help speed up the new patient registration process.

Downloadable Forms:

  • Patient Health History Form (Complete through patient portal if you’re able to do so)
  • Patient Demographic Form
  • Authorization to Send Medical Records
  • Authorization to Obtain Medical Records
  • Release of Medical Information Form
  • Financial Policy
  • HIPAA Notice of Policy

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

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“I loved my whole experience here; everyone is so sweet and very nice and professional. Dr. Kelly makes you feel safe and welcomed and he answers any questions you have. My delivery was smooth and easy, and I was in great hands!”

- Miyah M.

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At Doctors for Women, We offer quality Gynaecology surgery, Diagnostic testing, Gynaecology care & Obstetric Care for girls and women of all ages in the greater Houston, Texas.