First Time to Our Office?
When you come to our office for the first time as a new patient, we'll ask you to complete some initial forms, including an Authorization and Consent for Treatment form.
Remember to bring:
- Your insurance card
- Valid photo ID
- List of current medications
- Office co-pay
In an effort to respect the time of all of patients, our staff strives to stay on schedule so that other patients do not have to wait.
Patient Forms
Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Office Policies
Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.
Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.
Learn More About Our Primary Care Locations
Did You Know? Walk-In-Care is associated with two of the top local primary care providers in the area? Operated by both Central Virginia Family Physicians (CVFP) Medical Group and Physicians Treatment Center (PTC), you have the ability to become a patient at either one. To learn about either primary care provider, click on their logo below.
