Also serving Stafford & King George
Patient Forms
As a new patient, we will need you to complete a few quick forms prior to your first appointment.
Please download and print the document from the link below. Please answer all fields and bring the completed paperwork with you to your appointment.
- Patients Records Release
- Registration Consents (Updated)
- Registration Form
- Unaccompanied Minor Treatment Consent
Patient Access
Contact us to request access to EMA Patient Portal. When you enroll in our patient portal, you’ll gain access to:
- Review and update your medical records
- Access lab results, notes, and educational handouts
- Communicate with our practice
- Request prescription refills
Order Contacts
Patient Access & Forms
Quality Care Survey