Forms

 

 

 

Please click here to access our medical questionnaire forms on a secure page.

Forms filled out online will be automatically emailed to an Austin Area Birthing Center staff member who will contact you to set up your interview appointment.

Well Woman appointment forms available for secure online completion here.

 

**Please note that forms filled out electronically require some additional HIPAA paperwork to be completed at one of the two convenient Austin Area Birthing Center locations.

 

Additional helpful documents:

Checklist.pdf

pediatrician_list.doc

 

Verifying Benefits Through Larsen Billing Service

If you have insurance that you would like us to verify and bill for you please complete the client registration form through the link below so our billing service can verify your benefits. Please allow 48 business hours for verification to be completed and sent to our office. We would like to have your benefit information for you at your tour so please complete the client registration form as soon as possible.

1. Go to www.larsenbilling.com
2. On the PARENTS tab, select VERIFICATION OF BENEFITS
3. Select CLIENT REGISTRATION FORM.  Complete and submit form
4. To pay online, select PAY NOW. Note: there will be an additional $3 fee charged bythe debit/credit card company to pay online.
   • For other payment options, select PAYMENTS in the PARENTS tab on the website.