Patient Resources

New Patient Information

Welcome! We’re looking forward to a lasting partnership with you!

As you might expect, there’s paperwork to do. You’ll save time on your first visit if you take a few minutes now to gather the items you’ll need for that first appointment as a new patient. Please plan to arrive 30 minutes before your scheduled appointment to complete your registration.

Please be aware that there is a $25 no-show fee if you fail to notify us that you will be unable to keep your appointment.

New Patient Form

New patients should complete the Online New Patient Form before their appointment. If you are unable to sign the form electronically, you can download the New Patient PDF form (Papeleo Para Paciente Nuevo). You can  email the form to us at medrec@vpfw.com, bring it with you to our office, fax it to us at (804) 897-9074, or mail it to our office:

Attn: Medical Records
Virginia Physicians for Women
10710 Midlothian Turnpike
Richmond, VA 23235-4759

For virtual telehealth visits, you will need to complete the form online, or email, fax or mail us the signed PDF version. Call 804-897-2100 if you need us to send you a printed version of the form to return.

If you were referred to VPFW by another physician, or you are a new patient with us, please have your physician send a copy of your medical records to our office at 10710 Midlothian Turnpike, Suite 200 Richmond, Virginia 23235, or fax to 804-897-9074.

If the patient is under 18 years of age, a parent or other financially responsible party MUST sign all forms prior to the patient’s appointment. The patient should bring these signed forms with them to their appointment and present them at check-in.

By law, minors may come to VPFW without parental consent for the following services: pregnancy, birth control and STI testing and treatment.

Mammography Release Form

Mammography Release Form

Formulario de Permiso para Liberar las Imagines de Mamografia