We would like to know as much about you and your health prior to your first visit.  To help us prepare for your first visit, please download and complete the following forms and return them to us prior to your first visit.  You can download, save, and fill them out on your computer, or print and complete them by hand (with a black pen).  Please review the following checklist prior to your first visit:

 
                                            NEW PATIENT CHECKLIST 

1.    Referral.  We request that you obtain a referral from your primary care physician. 
Please call their office and request that they fax the referral once you have an
appointment scheduled with us.

2.    Medical Records.  Once you have an appointment, please call your primary care 
physician's office and request them to fax a  copy of your medical records to us at 
fax (804) 423-3637.

3.    New Patient Forms.  Please download the "New Patient Forms" by clicking on
one of the icons on the left. If you have any trouble downloading the forms, please
contact us and we can email you the forms.

If you are using Microsoft Word, then download the Microsoft Word version (click on the icon to the left).  You may fill them out on your computer then print them, or you may print and complete them by pen (not pencil).  This verson will only work with Microsoft Word.
MICROSOFT
           WORD

     
If instead you are using an Apple/Macintosh, or any non-Microsoft Word word processor, then download the Adobe PDF version of the forms (click on the icon to the left), print them, and complete them using a black pen (not pencil). 
PDF VERSION
   

        Please fax the completed forms to (804) 423-3637 at least 3 days prior to 
        your visit and also bring these forms with you to your first visit.  If you do not
have access to a fax machine, please mail them to our office at least one week 
prior to your visit.  If you have not sent the forms prior to your visit, please arrive at 
least 30 minutes early for your appointment and give these forms to the 
receptionist.

4.    Insurance Card.  Please bring your insurance card to your visit.

5.    Medications.  Please bring all of your medications to your visit.

6.    Patients with Diabetes.  If you have diabetes, please bring your blood sugar 
       machine and blood sugar record. For the week prior to your visit, we request that
you check your sugars 4 times a day (before each meal and bedtime) and bring
these numbers written down to your appointment.

If you have any questions, please feel free to call us at (804) 423-3636.