Patient Forms
To make check-in as efficient as possible, you may print the following forms and complete them prior to your visit. Please bring each form with you on the day of your appointment.
New Patient Registration
Your contact, pharmacy and insurance information.
HIPAA Privacy Policy September 2013
Your information. Your rights. Our responsibilities.
Medical Records Release
Authorize the release of your medical records.
Patient Medical History
Your medical history and current healthcare needs.
Consent to Treatment and Permission to Discuss PHI
Consent to treatment and financial responsibility, and with whom you would like that information shared.
Notice of Privacy Practices
How information about you may be used and how to access this information.
NCR Patient Opt-Out Form
Tell us if you would like to be considered for clinical trails in conjunction with NCR.
Locations
We offer many convenient offices In & around the Richmond area.
Providers
Learn more about our Providers at Commonwealth Primary Care.
News
Find out important information, updates & changes to our practice.