New Patient Information
Forms
Getting Started
Prepare for Your First Appointment:
- Select one of our convenient locations: Cana, Ferrum, Floyd, Fries, Grayson Highlands, or Laurel Fork.
- To save time, please complete the New Patient Registration Form BEFORE your first appointment. This online form is available at the top of your chosen clinic's page. Or you may request a paper form from your preferred location.
- If you are transferring your medical records, please complete the “Authorization to Release Information” form so that we will have access to your medical records before your first appointment. This form is available on your chosen clinic page. Or you may request a paper form from your preferred location.
Schedule an Appointment
- Select one of our convenient locations: Cana, Ferrum, Floyd, Fries, Grayson Highlands, or Laurel Fork.
- Call to make your appointment
When You Come for Your First Appointment:
- Please arrive 15 minutes before your scheduled appointment time.
- Be sure to bring along any medication you are currently taking.
- If you are applying to our Sliding Scale Program, bring along ALL of your proof of income information so there is no delay in approving your application.
New Patient Forms/Formularios para pacientes nuevos
Please read or complete these forms online BEFORE your appointment.
Por favor, lea o complete estos formularios ANTES de su cita.
New Patient Registration Forms
Electronic forms are available for all clinics. Please see your clinics location page to fill out forms online. Or you may request a paper form from your preferred location
Formularios de Registro del Paciente Nuevo
- Por favor, solicite los formularios a nuestra oficina antes de su cita. O puedes solicitar un formulario en papel desde tu ubicación preferida.
Notice of Privacy Practices
Aviso de Prácticas de Privacidad
Other Forms/Otras Formularios
Miscellaneous forms/Formularios varios
Authorization to Release Information
Electronic forms are available for all clinics. Please see your clinics location page to fill out forms online. Or you may request a paper form from your preferred location
Divulgación de Registros Médicos
Por favor, si estás transfiriendo tus historiales médicos, solicite formularios a la oficina local de Tri-Area. O puedes solicitar un formulario en papel desde tu ubicación preferida.