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FEMCARE - Robert Bass, MD , FACOG

Call for an Appointment: (954) 472-2201

  • Patient Forms
  • Book an Appointment Now
MENUMENU
  • Home
  • Meet Dr. Bass
  • Obstetrics
  • Gynecology
    • ESSURE® & Tubal Ligation
  • NovaSure
  • BOTOX / MD AESTHETICS
  • Cosmetic Procedures
  • Contact & Insurance

Patient Forms

Thank you for selecting FEMCARE OB/GYN in Plantation, Florida for your obstetrical and gynecological care. To schedule an appointment with Dr. Robert Bass, please call us at (954) 472-2201 or you can book one online.

Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process.

Please be sure to bring forms with you to your first visit along with your insurance card, necessary referrals, and any diagnostic films or other test results that may have been ordered or performed by another physician.

Established patients can update forms online through our patient portal. If you need help accessing the portal, please call the office and we’ll be happy to help.

DOWNLOAD PATIENT FORMS:

  • Patient Information
  • Release of Records to Dr. Bass
  • Office Policy
  • Notice of Privacy Practices (HIPAA)
  • Authorization for Treatment

BOTOX® FORMS

  • Botox Medical History
  • Consent to Botox Treatment
  • Pre-Treatment Instructions
  • Post-Treatment Instructions

ESSURE® FORMS

  • Procedure Consent Form
  • Pre-Op Instructions
  • Post-Op Instructions

CIRCUMCISION

  • Consent Form and Post-Op Care

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FEMCARE - Robert Bass, MD , FACOG

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Patient Education

Learn more about women's health issues and treatments in our interactive patient education center.

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Testimonials

“I love this office. The office staff is always warm and welcoming. Dr. Bass took his time to hear my concerns and together create a timeline to address everything. I always leave here feeling that I am a valued patient.” – Jenny Q. from ZocDoc

LEARN MORE

  • NovaSure
  • Botox
  • Essure
  • MD Aesthetics
  • Home
  • Patient Forms
  • Book an Appointment
  • Meet Dr. Bass
  • Obstetrics
  • Gynecology
  • NovaSure® Endometrial Ablation
  • ESSURE® & Tubal Ligation
  • BOTOX / MD AESTHETICS
  • Cosmetic Procedures
  • Contact & Insurance

Our Location
Bennett Medical Building
201 NW 82nd Avenue, Suite 104
Plantation, FL 33324
(954) 472-2201

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At FEMCARE OB/GYN in Plantation, FL, Dr. Robert Bass is a board-certified obstetrician and gynecologist who specializes in obstetrics, gynecology, permanent tubal ligation with ESSURE®, NovaSure® endometrial ablation, cosmetic vaginal surgery,  BOTOX / MD AESTHETICS.