New Patient Information

In order to serve you better and faster, we have provided our New Patent Information Form online. Click on the link below to access the New Patient Information Form. When the browser window opens, click on the ‘PRINT’ icon. Complete the forms and bring them with you on your first visit. You may also fax it to our office at (Richmond) 804-934-9381, (Farmville) 434-391-1254. Completing the New Patient Information form in advance will save you time on your initial visit!

DOWNLOAD NEW PATIENT REGISTRATION FORMS (PDF)

VIEW HIPPA PRIVACY STATEMENT (Read, but no need to send)

 

Your First Visit

On your first visit, you will be greeted by the receptionist and asked to complete the New Patient Information Form if you haven’t already done so. You will need to bring your current insurance card, photo ID and payment, as insurance required us to collect your copay and deductible amounts at the time of service. The New Patient Form is very important as it gives us the needed information on how to reach you by mail, phone or email, as well as tells us briefly about your past and present medical conditions and your family history. We ask for your current insurance information so that we can properly bill your insurance company. It also tells us the name of your primary care physician (PCP) in case our doctors need to contact him/her or send information.

The “Notice of Privacy Practice” is your key to privacy and describes how your health information may be used and disclosed. It also describes how you can access this information. The “Notice of Privacy Practice” provides the medical community with needed information to assure that you are receiving the best possible medical care available. Accurate communication can be the fastest way for effective emergency care if it is needed.

Next, the medical assistant will review your current and past medical history with you. You will be asked to explain why you are visiting us today so that we’ll know what kind of x-rays, if any, need to be taken. When the medical assistant is finished, x-rays will be taken of both feet and ankles. The doctor will then go over your current and past medical history with you again as well as discuss your current medications. He will review your x-rays with you, discuss current conditions and review and past treatments. Finally, he will discuss with you the treatment options available for your specific foot condition.