Become a Patient

Become a New Patient

We are currently accepting new patients into our practice. Thank you for considering us. To become a new patient:

  1. Complete the new patient paperwork and mail to the office
  2. Once the paperwork is received, an office staff member will call to schedule your appointment

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, if you were not able to complete them in advance of your appointment.

Please arrive 15 minutes prior to your first appointment to make sure there are no delays in care during your first visit experience. We will need to ensure that your registration is complete before having you meet with your new provider.

Remember to bring:

  • Your insurance card
  • Valid photo ID
  • List of current medications
  • Office co-pay

To respect the time of all of our patients, our staff strives to stay on schedule so that other patients do not have to wait.

For patients who are delayed and arrive late for appointment, every effort will be made to see them the same day. However, wait times may apply, or appointments may need to be rescheduled.

Praises or Concerns

Please feel free to contact our Practice Administrator with your praises or concerns. You may ask for them when you call the main number and they will get back to you as quickly as possible

Office Information

Housekeeping

Patient Self Assessment


School Forms

Albemarle Medical Authorization

Charlottesville Medical Authorization

Fluvanna Medical Authorization

High School Athletic Participation

School Entrance Health Form

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.

HIPAA Privacy Notice