Patient Forms at Oyster Point Family Practice in Newport News, VA

Patient Registration Form

Registration for New Patients or Patients that haven’t been seen in 5 or more years

Financial Policy Form

Please read and sign this form. Simply states that you are responsible for your bill and that we are permitted to bill your insurance.

Patient Medical History Form

Please fill in your/patient medical history as thoroughly as possible. Include the year of diagnosis or surgery and family history and relation to family member where applicable.

HIPAA Acknowledgement Form

This form states that you have read the HIPAA Notice of Privacy Practices on the HIPAA tab on this website and that you understand the information. Also, please designate the desired people you wish to have access to your medical information as stated on the form. Please Sign and Date.
Authorization for Release of Information – Compound Release. Who can have access to your medical information.

Patient History Form (Side 2)

Please fill in this reverse side of the patient medical history form as thoroughly as possible.

Authorization to Release Health Information

Please fill out this form if you have medical records from another doctor’s office that you would like have sent to our office. This form can also be used for existing patients if they require us to send records elsewhere.