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PATIENT FORMS

We have automated many of our services.  Please submit an appointment request and we will contact you to establish access to our new patient portal to complete patient registration.

Appointment Request Form 

Provider Referral Form 

If you prefer not to use our portal, please call our office at (804) 249-2465 to schedule your appointment and talk through patient registration.

If you are already one of our patients and need to schedule your next colonoscopy, you may submit an appointment request online or download the Recall Colonoscopy Registration Form and mail it to us for scheduling: 

Recall Colonoscopy Registration Form

To obtain a copy of your medical records, please call 804-249-2465.  There is a processing fee of $10 plus $.50 per page. These fees, set forth by Virginia State Law, must be paid in full before your request can be processed.  This form will also need to be returned before your medical records can be released.

Patient Request for Medical Records

West End

7605 Forest Avenue, Suite 308
Richmond, VA 23229
(804) 288-7077
(804) 285-8120 fax

Hanover

7425 Lee Davis Road
Mechanicsville, VA 23111
(804) 559-3400
(804) 559-3362 fax

Stony Point

8700 Stony Point Parkway, Suite 270
Richmond, VA 23235
(804) 249-2465
(804) 249-2461 fax