Patient Resources
Patient forms
Printing tip: print each form single-sided, one page per sheet, so it scans correctly at check-in. On the day of your visit, staff may ask you to sign billing and check-in forms or a waiver.
Patient portal: before registering, call any NVOA office to get the Practice ID and security code.
New Patient Registration Form
Registration and health history for your first visit.
Pediatric Medical History Form
Health history for patients under 18.
Minor Consent Form
Permission for a child to be seen without a parent present.
Medical Records Request Form
Request copies of your records or send them elsewhere.
Practice Policies & HIPAA Acknowledgment
Office policies and privacy acknowledgment.
Notice of Privacy Practices
How we use and protect your health information.
Need a form in a different format? Call (703) 534-3900 and we’ll help.
Ready to schedule?
Request an appointment online or call the office closest to you.
- Falls Church(703) 534-3900
- Fairfax(703) 620-2701
- Alexandria(703) 922-0906