Below you will find the following forms:

The consent form is required to be thoroughly reviewed, printed, signed and either electronically emailed, mailed or brought into our office before a new patient appointment is made for you. 

The medical history form and registration form should be printed, filled out completely, and brought to your new patient appointment.  If unable to do this prior to your appointment, we will have these at the office but please remember to come 20-30 minutes prior to your appointment time to get them completed.

**please bring all of your insurance cards to all appointments**

***Please know that we are a multispecialty clinic and

you may have to pay the higher copay according to your insurance***

 please bring any records that you have or a list of providers that we will need to get records from and your medication list. 

 PATIENT QUESTIONNAIRE

At Healing Hands, our mission is to create an environment where practitioners focus on wellness, healing, and treating the whole person.  In keeping with that vision, our practice consists of Board-certified Family Nurse Practitioners, with autonomous practice license in the State of Virginia. 

**the questionnaire has to be filled out completely or it will not be reviewed.  we will not be calling individuals to fill in information left out on the form.** 

Do not leave out any diagnoses or medication(s) as this could cause an issue with moving forward in your care even if you are scheduled for a new patient appointment.

You must put the name of your insurance(s) along with the ID and group numbers on the form, no exceptions. 

once the form below is submitted, we will get back to you within 30 days.

Thank you, The Healing Hands Team!