Patient Forms

Please fill out the new patient forms and bring them to your appointment.  If you have insurance, you are required to present your insurance information and valid photo identification at the time of check-in. If you have a new problem, please complete the patient history form. If it has been more than a year since you have been to see us, please complete both the registration and history form.

Also attached is the privacy form for you to designate a contact who we may speak to in your absence about your account, appointments and medical information.

Download Forms

Print forms and fill them out prior to your arrival and bring them with you to your visit.

If you are unable to download these forms, you may need to download  Adobe Acrobat Reader. Please click here to download Adobe Acrobat Reader.

Fredericksburg Office

2800 Wellford Street
Suite 100
Fredericksburg, VA 22401

Massaponax Office

9530 Cosner Drive
Suite 101
Fredericksburg, VA 22408

Office Hours

  • Mon. – Thurs. 7:30am – 4:30pm
  • Friday 7:30am – 4:00pm
  • Saturday & Sunday Closed
Patient Portal Login
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Patient Portal

Easy. Convenient. Secure.

Use our safe & secure patient portal for 24-hour access to your personal medical records and to fill out your patient forms online.

Patient Portal Login

Need to set up an account? Call (540) 361-1930.