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913-948-9636
913-948-9643 fax

Overland Park, Kansas

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Medical Records Transfer Authorization Form

Below is our Medical Records Transfer Authorization Form. In order to have your records securely transferred to Kansas City ObGyn from a previous medical provider, we ask that you simply print out this form, sign and date at the bottom and fax it to our office at 913-948-9643.  

If it is more convenient, you can also scan the signed form and email it to us at This email address is being protected from spambots. You need JavaScript enabled to view it. or simply bring the document to our office during your next appointment.

Medical Release to our office Medical Release from our office

Medical Release
to our office

Medical Release
from our office

Patient Information Form

Please complete all pages of the Patient Information Form below and bring them with you to your next appointment. Filling these patient information forms in advance of your appointment can save you time in the waiting room and ensure a quick and accurate visit!

Patient Registration Forms