FOR NEW PATIENTS

When visiting our office for the first time, please be prepared to answer questions about your child’s health history, medications, allergies, family health history and other health-related issues.

New Patient Forms

Please print these forms and complete them before your first visit:

download the HIPAA form for patients 17 and younger
download the HIPAA form for patients 18 and older

download the personal information form for patients 18 and older
download the personal information form for patients 17 and younger

In addition to the new patient forms, please bring a copy of your child’s vaccine records to your first appointment. With your written permission, your previous medical provider can fax the records to our office at 804-358-3107, but be aware that it may take as long as 30 days to obtain this information. You may also request a copy of your child’s health records from your previous healthcare provider in person. WE CANNOT ADMINISTER VACCINES IF A VACCINE RECORD IS NOT AVAILABLE, so please confirm that we have received your child’s record before your visit.