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 complete your e-registration form ahead of time or print and fill out a PDF copy to bring with you to your appointment. Otherwise, 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.
How to Complete the New Patient Registration Form
After making an appointment, new patients will be emailed and/or texted a link to complete their e-registration form. This will be sent to you up to 10 days before your appointment date. Please complete your e-registration before your appointment. If you are unable to sign the form electronically, you can print the New Patient PDF form (Papeleo Para Paciente Nuevo), fill it out and bring it with you to your appointment. Alternatively, you can email the form to us at email@example.com or fax it to us at (804) 897-9074.
Call 804-897-2100 if you need us to send you a printed version of the form to return.
For virtual telehealth visits, you will need to complete your e-registration form online or email or fax us the signed PDF version before your appointment.
New Patient Medical Records
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 firstname.lastname@example.org, mail to 10710 Midlothian Turnpike, Suite 200 Richmond, Virginia 23235, or fax to 804-897-9074.
New Patients Who Are Under 18
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. There is an option for a parent or financially responsible party to sign the e-registration form electronically, or the patient can bring the signed forms with them to their appointment and present them at check-in.
By law, minors may come to VPFW without parental consent or signature for the following services: pregnancy, birth control and STI testing and treatment.
Mammography Release Form for New Mammography Patients
If you are a new mammography patient at VPFW and your previous mammograms were not performed at an HCA or Bon Secours Mercy Health facility, please obtain the CDs of your images prior to your appointment. Most facilities require patients to complete a Mammography Release Form (Formulario de Permiso para Liberar las Imagines de Mamografia).
You can fill out the form and either send it to the facility that conducted your prior mammogram(s) yourself, or you can bring it to VPFW and we can request the images for you. Please be aware that most facilities require advance notice to prepare your mammography images, so please contact them as soon as possible if you plan to pick them up yourself.
If you have any questions, don’t hesitate to call us at 804-897-2100. We look forward to caring for you!