THE PHYSICIANS
OFFICE LOCATIONS
PATIENT INFO
CLINICAL RESEARCH
RESOURCES
patient information
What to
bring to your initial appointment
INITIAL APPOINTMENT
To make certain that you receive the time and attention required to
provide optimal care, we ask that new patients arrive 15 minutes prior
to their first appointment to complete the necessary registration process.
New patients are requested to bring to their initial appointment:
- Insurance card
- Referral forms and co-payments
- Copies of pertinent diagnostic tests and medical records
- All current medications
- Completed Patient Registration form, Medical History form and Physical form (if available)
To help us provide you with optimal care, if you have been hospitalized or had cardiology testing at another facility, please have copies of the reports sent to our office prior to your initial visit.
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of page PATIENT FORMS
NOTE: The following forms are Adobe PDF
files. You will need Acrobat Reader to view (get
the Reader plug-in if
you don't
have it).
Please print forms, fill out and bring in with you for your initial appointment.
Patient Registration
New Patient Medical History
Treatment and Payment Policies
Permission to Release Medical Information
Consent to Use and Disclosure
of Protected Health Information
Notice of Privacy Practices (HIPAA)
Written Acknowledgement
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to top of page
INSURANCES WE ACCEPT
Aetna
Alliance PPO
Anthem Blue Cross/Blue Shield
Anthem Healthkeepers
Cigna
Humana
Humana Gold
MAMSI
Medicaid of Virginia
Medicaid of North Carolina
Medicare
Optima
Optimum Choice
Sentara - all products
Sentara Family Care
Tricare
Tricare Prime
Virginia Health Network
United HealthCare
Please call the Business office if your insurance is not listed: 757-499-2825.