Mansfield Miracles, Paul Daum, MD
Patient Forms
Caring for Women at Every Stage of Life
Gynecology appointments now resuming!
In order to reduce risks of exposure to patients and office personel, during the covid pandemic we have restricted office visits to OB patients and gynecology patients with urgent problems. We are now reopening appointments to routine gynecology patients. We will remain in complicance with Covid recommendations by limiting volume of patients such that there should only be one patient in the waiting room at any time. If you have a mask, please wear it. if not, we will provide one on arrival. We would encourage you to not bring family members to your visits. If you have signs of, symptoms of, or exposure to covid please reschedule your visit. Be safe, but come see us!
| Form Name | Form |
|---|---|
| Authorization to Release Information | Download Form |
| Introduction Letter from Dr. Paul W. Daum | Download Form |
| New Patient Enrollment | Download Form |
| Patient Medical History | Download Form |
| Pregnancy Questionnaire | Download Form |