Welcome to Trust Women's Health
This guide covers everything you need to know about visits, exams, procedures, menopause management, portal messaging, and our approach to care.
Welcome!
It is my joy and privilege to welcome you to my practice. 2025 is a milestone year for my career – 20 years as a nurse, 15 of those as a Women's Health Nurse Practitioner. I do not take for granted what an incredible honor it is to care for you and how very vulnerable seeking care for gynecological concerns is. My top priority is that you feel safe and empowered in my care.
I chose the name Trust Women's Health for many reasons. "Trust Women, Respect Choice" is a pro-choice refrain and a primary motivation in my leaving a healthcare corporation with restriction to abortion. I also chose 'Trust' to reflect the rapport and respect it takes to do excellent gynecological care. I understand that trust is earned and not freely given. My goal as your provider is to earn and maintain your trust.
Trust Women's Health Visits
I offer both virtual and office visits. Virtual visits may be completed by video, phone, or via portal message.
Screening preventive gynecological (well woman) exams are done in office only and may include a physical exam, though is not mandatory. Pap and HPV testing intervals vary based on age and past cervical cancer screening history.
A yearly screening gynecological exam is recommended by the American Congress of Obstetrics and Gynecologists (ACOG) and the Women's Preventive Services Initiative (WSPI) and is paid for by nearly all insurance plans. Medicare pays for this exam every two years. Exams may start in adolescence, with Pap recommendations beginning at age 21.
Learn more about Well Woman Visits
What to Expect at Your Annual Exam
Screening preventive gynecological exams are separate from your primary care annual exam. I am not a primary care provider. I highly encourage you to have a relationship with a primary care provider in addition to me.
I do not treat non-gynecological concerns and cannot order tests for conditions that I do not manage. For example, I do not treat respiratory infections or prescribe thyroid medications. I also defer to primary care to order your screening lab tests (lipid panel, diabetes screening) as they manage the conditions associated with these screenings.
Annual screening exams may include:
- Vital signs
- Review of history, medications, and pertinent vaccinations
- Physical exam
- Recommendations for screenings like STI testing or mammogram
- Refills for established medications like contraception or hormone therapy
Please note: Addressing concerns like heavy bleeding or pelvic pain, or a prolonged consultation for menopause symptom management can be done on the same day as an annual exam but will be subject to additional billing in accordance with government mandates from Center for Medicare and Medicaid (CMS). See our financial policy for more information.
Exams and Procedures: Your Comfort Matters
Pelvic exams are challenging for many patients. I am committed to making your exam as comfortable as possible!
Your Rights:
- You have the right to refuse any physical exam, including a pelvic exam
- I will not withhold treatment or medication in exchange for physical exam completion
- You can withdraw your consent and discontinue an exam or procedure at any time
I do have an obligation to have a yearly visit with you to continue medication therapy – in some cases, this can be done virtually. I will share my recommendations for treatment and for exams and the rationale, but your consent must be granted to me to proceed.
Alternative Options:
There are alternative options to an exam in many circumstances, for example self-collection of swabs for STI or vaginitis concerns.
Comfort Measures Available:
We can also consider a virtual or in-office consultation visit to prepare for an exam or procedure. At that time, we can discuss comfort measures including:
- Nonsteroidal anti-inflammatory (NSAID) medications
- Local anesthetic (numbing) medications
- Light sedation
Read ACOG's guidelines on pain management for gynecological procedures
Menopause Management
I have maintained certification with The Menopause Society (formerly North American Menopause Society or NAMS) as a Certified Menopause Practitioner since 2013. I use their recommendations for guiding practice and prescribing therapies.
It is in accordance with their recommendations that I do not prescribe compounded hormone therapy or pellet therapy.
Read The Menopause Society's 2022 Hormone Therapy Position Statement
Lab Tests and Imaging
All lab tests collected in clinic (Pap tests, STI screens, biopsies, etc.) will be sent to LabCorp unless you specify a preference for Quest. Results from both LabCorp and Quest will integrate directly into your Elation chart.
You may choose where you opt to have serum (blood) testing and imaging done. I do not have breast imaging, ultrasound, or serum testing available in clinic. I will have information on locations for LabCorp and diagnostic imaging in office and on my website.
I will send you lab result reports via portal message. Imaging and some abnormal lab results are best addressed via a phone or brief virtual visit.
Portal Messages
I use the electronic health record (EHR) Elation and its portal system Patient Passport. This portal is separate from "My Chart" and "My Virginia Mason" portals.
Portal messaging is an excellent communication tool but is not ideal for all communications. I may request you make a virtual visit or that we arrange for a portal messaging visit for prolonged questions or if there will be several back-and-forth messages between us. I will request your consent for a portal visit if your message meets this threshold; insurance may be billed to account for our time communicating.
I will make every effort to respond to messages within 48 hours.
Medical Records
I have read-only access to Cerner, meaning I can read our past visit notes from Virginia Mason Franciscan Health (VMFH) and see past lab tests as well as access current notes from your other VMFH providers who use Cerner.
There is also information sharing with other health systems that use Epic through the Elation Carequality function. Since I do not belong to either Cerner or Epic systems, release of information forms may be necessary in order to access your health information from elsewhere.
Referrals
In the event you have a concern or medical finding that is outside of my scope of practice to treat, I may refer you to another medical provider. Examples include surgical consult for tubal sterilization, fibroid and polyp management, and/or hysterectomy.
Referrals to other specialties may be more appropriate to be completed by your primary care provider.
Infection Control
I intend to wear a mask during cold and flu season as well as when there are COVID surges in the community. You may wear a mask if you'd like, but it is not required. I will supply surgical masks in office.
Please do not come to an office visit with upper respiratory symptoms – reschedule or request to opt for a virtual visit.
I recommend flu and COVID vaccines and intend to offer them in clinic; you are welcome to decline.
If You Are Pregnant
I do not provide prenatal care. I recommend establishing with an obstetrical practice if you are pregnant; referral from me is not necessary to establish care.
I provide medical abortion up to ten weeks of pregnancy; I do not provide surgical abortion. Surgical abortion does not require referral.
Termination of Care
My style of practice may not be for everyone; if we are not a match, you are welcome to establish with another provider at any time.
Our relationship is built on clear communication and mutual respect. If we have had a miscommunication or if you have felt disrespected by me or one of my team, please notify me. I am happy to address it and work to regain your trust.
Abusive or threatening behavior towards me or my team will not be tolerated. Repeated no shows or last minute cancellations may also be grounds for termination of care.
LGBTQ+ Care
While my clinic name is Trust Women's Health and my board certification is as a Women's Health Nurse Practitioner, I care for folks who do not identify as women. Nonbinary folks and trans men, you are welcome here.
I am committed to providing inclusive and affirming care to you. I acknowledge that accessing care is especially vulnerable for you and that you may have experienced poor treatment or disrespectful medical care in the past. I will work to meet you where you are so we can build a trusting partnership.
Prescribing trans hormone therapy is not yet in my scope of practice, but I hope to gain that skill in the near future. I am happy to refer you to a provider if you have needs that I cannot meet.
Thank You for Joining Me
I recognize the effort it takes to fill out more medical history forms, find a new location and sort parking, and to open YET ANOTHER portal account! I appreciate the incredible support so many of you have given me over the years.
It is my relationship with each of you and my desire to give you the healthcare experience that you deserve that has motivated me to open Trust Women's Health. Please be patient with me as I learn how to be a clinic owner; this experience has humbled me to my core! I welcome your feedback and constructive criticism so I can make this clinic all it can be!
I can't wait to return to patient care and to care for you!
All my best,
Kate Behning, ARNP