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Fax Number: 804-378-5400
ATTENTION: Due to exceptionally high call volume, our response time to phone messages may be delayed. To ensure we can assist you as quickly as possible, we encourage you to use our Patient Portal for non-urgent communication.
Patient Forms
Patient Records Release Form
PDF download
This allows us to send your records to other providers.
Medical Records Request
PDF download
This form is used to request your records from other physicians (for established patients only)
Downloading Forms:
Download forms from the comfort of your home and decrease appointment wait times by filling out registration forms before your appointment!
Patient Portal Registration Instructions
If you are interested in registering for our patient portal these detailed instructions will walk you through the process.
Virginia Board of Medicine Opioid Guidelines 2017
In 2017, the Virginia Board of Medicine released new guidelines for prescribing opioid medications. You can read these updated guidelines here.
​Privacy/HIPAA Policy
We strive to provide the utmost privacy to our patients.
ESTABLISHED PATIENTS:
Need to submit a form?
Medical Records:
Fax: 804-378-5400
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All forms submitted by mail should be mailed to our secure P.O. Box at:
3420 Pump Rd. #160 Richmond, VA 23233
Forms can also be delivered to our office during normal business hours at:
14404 Sommerville Ct. Midlothian, VA 23113
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