Due to COVID-19 we are trying to go as paperless as possible to reduce the odds of contact and office waiting room transmission. However, we know that our patient base may have a particularly hard time with this request, so we are trying our hardest to make it as easy for you as possible. If you are having trouble at all please call us at 804-387-2902 or email us questions to firstname.lastname@example.org.
Please fill out all forms for your specific appointment type PRIOR to your initial evaluation/appointment.
New patient intake forms may take 30-60minutes for some patients,
or may trigger symptoms, so please plan accordingly.
How to fill out and send the forms – please choose the option that is easiest for you:
Download the new patient intake forms, fill them out by hand and Fax to 804-509-0543
Download the new patient intake forms, fill them out and email them to us securely.
To securely email your forms in a HIPAA compliant way we will need to send you a secure email. Please email us at requesting a secure email link. Once we replied back to you through the secure portal you can securely send us your forms.
Please don't just email your forms to us without the secure portal as your personal email may not be HIPAA compliant
For help with opening your secure email from us please click here
Access an online version of the patient forms through the Patient Fusion portal (see below), and complete all information through the online form.
Patient Fusion Information
We offer you access to your own personal web portal through PatientFusion, which is a HIPAA compliant and secure patient portal to enable communication between you and your doctor. The portal can be used to obtain your records, message your provider, request appointments, and fill out your patient intake forms prior to your appointment. This portal is not for urgent issues, messages sent through the portal will not be checked until the next business day.
To help you navigate the patient portal as easily as possible, we created this step by step guide with pictures to help you create your account and get started.