The health information on this website is provided solely for informational purposes for patients of Women’s Health Advantage (“WHA”). The health information does not constitute medical advice and is not intended to be a substitute for proper medical care provided by a licensed and qualified health care professional. WHA assumes no responsibility for any circumstances arising out of the use, misuse, interpretation, misinterpretation or application of any health information supplied on this website. Do not rely on health information on this website as a tool for self-diagnosis. If you have a specific medical condition, please schedule a visit with a WHA medical professional.

Welcome to Women’s Health Advantage!

We are excited for you to join our community of incredible providers and patients. Our team is happy to assist you if you have any questions.

Prior to your first appointment, please complete the following forms using the links below. This will help to make your check-in experience much more efficient.

Financial Consent

Phone Waiver

Health History WHA

New Patients* — Please arrive 30 minutes prior to your scheduled appointment time so you can complete additional forms required for your initial visit. Please bring a copy of your insurance card and photo ID, and be ready with your co-pay, if applicable. For self-payments, please make sure your payment is ready when you arrive at your appointment.

*Please note that ALL patients under 18 years of age must be accompanied by their parent or legal guardian at their first appointment. The legal guardian also must bring a copy of guardianship papers with them to the initial appointment. At this appointment the parent/legal guardian can complete a minor consent form that will allow the minor to be seen for most appointments without their parent/legal guardian present.

Established Patients — Please arrive 15 minutes before your scheduled appointment. Please make sure to have your insurance card, photo ID and co-pay ready if needed. You may need to complete additional paperwork at your visit depending on the last time you were seen by our providers.

Medical Record Requests

Requesting Records FROM WHA

Form: To request your personal medical records, you must complete every section of the Release of Information form.

Fee: If your request includes 10 pages or more you will receive an invoice in the mail for $6.50. This fee is for the processing, supplies, and postage if needed. The fee must be paid before records will be released.

Method of Release: Any records that are over 10 pages will be put onto a disc. Paper copies are available at a charge per page. Our office does not email records to patients.

Timeframe: By law, we have 30 days after the receipt of the request to release medical records. If you are requesting records for an upcoming appointment with another office and they need them urgently, please have that office contact us.


Requesting Records to SEND TO WHA

Contact the facility needed to send records to WHA. If they need a Release of Information form to be sent, please complete the form and use WHA’s information as the “Receiving Entity.” We must have all of the Providing Entity’s information for us to submit the request on your behalf. Once the form is completed, please fax, mail, or drop the form off to our office.

Fee: There is no fee for us to request records.

Our mailing address:
Associated Surgeons and Physicians
2518 E. Dupont Rd.
Fort Wayne, IN 46825
FAX (260) 969-6898


How do I access the patient portal?

What insurance plans are accepted?

How do I submit FMLA / Short Term disability paperwork?

How can I pay my bill?