Appointment request
About 3 minutes
Patient Forms
Complete your forms online
Finish your paperwork before you arrive. Each form is completed here on our website over an encrypted connection, turned into a PDF, and delivered securely to the office for your chart.
New patients should complete registration, the consent forms, and the medical history before their first appointment. If you cannot finish in one sitting, you can return and start the form again — please submit each form only once.
Available forms
Four forms, each completed in one sitting
Allow about 20 minutes in total for all four if you are a new patient.
New patient registration
About 7 minutes
Everything the front desk needs to open your chart: demographics, contact and emergency details, pharmacy, and insurance.
Consents and policies
About 5 minutes
Consent to treatment, the financial and cancellation policy, telehealth consent, communication preferences, and your privacy acknowledgment.
Medical history
About 8 minutes
Your medical, medication, allergy, behavioral health, family, and social history, plus what you would most like help with.
Records release
About 4 minutes
Authorize us to request records from a previous clinician, or to send your records to another office or person.
SPRAVATO consultation request
About 5 minutes
Privacy
How your information is handled
Forms are transmitted over an encrypted connection and stored in restricted storage that only the practice can access. The office receives a notification with a private, time-limited link to your completed PDF; the details you enter are not sent through ordinary email.
Completing a form does not book an appointment and is not monitored in real time. For an urgent concern, call the office at 757-863-5843. In an emergency, call 911, or call or text 988 for a mental health or suicide crisis.
If you would prefer to complete paper forms in the office, arrive 20 minutes before your first appointment and we will provide them.
Ready to be seen?
Once your forms are in, book the appointment that fits your schedule.