Save time in the Waiting Room
Please fill out all three of the forms below before your first appointment. All forms are HIPPA-compliant and you will be able to download a PDF copy for your records once completed. To fill out the forms, click the buttons below and a new window will open where you can submit your information safely and securely. Please complete and submit each form before moving onto the next one.
Laboratory Form
As part of your care, there will be laboratory testing required. Some tests require an outside lab. In order to make sure you are afforded the highest level of benefits from your insurance company, please provide the information on this form.
New Patient and Family History Form
In order to build a comprehensive patient file, it’s imperative that we learn about you and your family’s history. Please complete the form below to the best of your knowledge.
New Patient Packet
Our New Patient Packet is essential to gathering all of the information we need to begin your treatment at HOAF. Please be sure to fill out each field and question as best as you can.
Release of Information Form
Often times records are required from outside resources for continued care.. To ensure we get these records in a timely manner we ask that you fill this out for any physician or hospital that may have records associated with the type of care that we are providing.
For requests of records to another physician, attorney or insurance group, you can email the form back to medicalrecords@hoafredericksburg.com. If requesting to pick up a copy for personal use, you will need to fill out and bring form in with ID. If unable to come into office, you can mail form to our Fredericksburg location. *Form must be notarized if mailed or faxed.
Download the Release of Information Form Here
