Release Forms

Release Forms

“Please try to fill out forms at least 48 hours prior to your visit, as they do take 1-2 days to populate into your chart. Thank you!”

If you are new to our practice and would like to schedule an appointment, please fill out our medical records release form and fax it to us at 207.885.8499. We will work on getting your medical records for you. Once we have received your release we will be more than happy to schedule your appointment.

If you are requesting your records be released from Coastal, please fill out this medical records release form and fax to 207.885.8499. Once we have received this form we will work on releasing your records.


At Coastal Women’s Healthcare, we accept and participate in many insurance plans/networks (see link below). Many plans require that you make a co-payment at the time of your visit. For your convenience, we accept cash, checks, Master Card and VISA. Please be prepared with your insurance card and co-pay at the time of your visit. If you do not have insurance and will be paying for services on your own, please complete our uninsured patient policy and bring it with you to your first appointment.

You can now pay your bill through your secure patient portal account.