Patient Forms

In an effort to make your appointment check-in process smoother and more efficient, here are a few of the common forms that you may fill out in advance of your appointment.

If you have questions, please call us at 540-785-7768. Our fax number is 540-785-7691.

Forms You May Need

New Patient Form

If you are a new patient for a Sentara Pratt Medical Group practice, you can download the form below. Print and complete the form, and bring it with you to your first visit.

Authorization to Disclose or Release Health Information

If you want to have a medical record transferred from another practice to your new Sentara Pratt Medical Group office, please complete this form. Likewise, this form can also be used to authorize someone other than you to have access to information about your healthcare status or treatment. Just print and complete the form and bring it with you to your next appointment.

Pediatric Medical History

Please print and complete the form, and bring it with you to your first visit.

Contact Sentara Pratt Medical Group

Have a question? Find a phone number in our department directory.

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