Welcoming Our New Patients - West Coast OB GYN

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Your Name

First Last

Your Email*

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Your Phone Number*

Do you have a sensation that there is a bulge in your vagina or that something is falling out of your vagina?*

Yes

Do you experience bothersome leakage of urine?*

Yes

In the past month, have you experienced accidental bowel leakage (liquid or solid stool)?*

Yes

Do you experience frequent urination?*

Yes

Name

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Sharp accepts most health insurance. If your plan is not listed below, please call your insurance provider to verify coverage.

Accepted Insurance Providers	Accepted Plans
Aetna Website	Aetna PPOs, HMO SCMG, Health Fund HMO SCMG, Open Choice PPO, Select Choice HMO SCMG, Traditional Choice PPO, Value Network HMO SCMG
Anthem Blue Cross Website	Anthem Blue Cross PPOs, HMO SCMG, EPO, Gold EPO, Platinum EPO, Prudent Buyer PPO, Silver EPO
Blue Shield Website	Blue Shield HMO SCMG, PPOs (contact Blue Shield)
Cash	Self Pay
ChoiceCare/Humana Website	ChoiceCare/Humana PPO
CIGNA Website	CIGNA HMO SCMG, Open Access POS, PPOs
Coventry Healthcare Website	Coventry Healthcare PPO
Health Net Website	Health Net PPO, HMO SCMG
Healthsmart	Health Smart PPO
Medicare Website	Next Generation ACO, Sharp Health Plan Sharp Advantage (HMO SCMG), UHC-AARP MediComplete Premier, UHC-AARP MediComplete Essential, UHC-AARP MedicareComplete Value, UHC-Secure Horizons Retiree, UHC-Sharp Secure Horizons
MultiPlan Website	PPO
Sharp Health Plan Website	Bronze HMO SCMG, Choice HMO SCMG, Gold HMO SCMG, Performance HMO SCMG, Performance Plus, Platinum HMO SCMG, Premier HMO SCMG, Silver HMO SCMG, Value HMO SCMG
Three Rivers Provider Network Website	PPO
Tricare Website	TriCare Prime, Standard
UnitedHealthcare Website	Choice HMO SCMG, Choice Plus POS, Options PPO, PPOs, Signature Value HMO SCMG, Signature Value PPO
VEBA Website	PPO

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