Contact Us: 361-578-5233

Victoria Women's Clinic
  • Home
  • Provider Directory
  • Gynecology
  • Obstetrics
  • Menopause
  • Contraception
  • In-House Laboratory
  • Patient Portal
  • Our Locations
  • Helpful Info
  • Forms
  • Request Medical Records
  • Employment Opportunities
  • Schedule An Appointment
  • More
    • Home
    • Provider Directory
    • Gynecology
    • Obstetrics
    • Menopause
    • Contraception
    • In-House Laboratory
    • Patient Portal
    • Our Locations
    • Helpful Info
    • Forms
    • Request Medical Records
    • Employment Opportunities
    • Schedule An Appointment
Victoria Women's Clinic
  • Home
  • Provider Directory
  • Gynecology
  • Obstetrics
  • Menopause
  • Contraception
  • In-House Laboratory
  • Patient Portal
  • Our Locations
  • Helpful Info
  • Forms
  • Request Medical Records
  • Employment Opportunities
  • Schedule An Appointment

 To help speed up the check-in process, please download and complete the necessary forms below (which are editable in PDF) and email to checkin@vwca.com.  If you are unable to email, please print the forms below and present them at the time of your appointment. Thank You!

Demographics Form (pdf)

Download

Records Release (pdf)

Download

Authorization to Release Info-PHI (pdf)

Download

OB Intake Packet (pdf)

Download

OB Intake Packet Español (Spanish) (pdf)

Download

BIOTE Female Packet (pdf)

Download

BIOTE Male Packet (pdf)

Download

Victoria Women's Clinic

Two convenient locations: 110 Medical Dr., Suite 100 (near Detar north) & 2705 Hospital Dr., Building B, Suite 300 (Across from citizens medical center)

361-578-5233

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