Patient Forms, Maps and Directions to the Chesapeake office
Your first visit to First Care PC establishes a vital foundation for our relationship with you. During your first visit, we make sure to obtain important background information about your medical history and give you time to get to know your provider.
To understand what to expect for your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more.
Our practice believes in: WORKING TOGETHER TO REALIZE A SHARED VISION OF EXCELLENCE IN MEDICINE.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earning the trust and respect of patients, profession and community.
- Exceeding your expectations.
- Ensuring a creative, challenging and compassionate professional environment.
- Striving for continuous improvement at all levels.
Please print and fill out these forms so we can expedite your first visit:
- Demographic Form
- Patient History Form
- HIPAA Form
- Notice of Privacy Practices (NPP)
- Assignment Release and Financial Agreement
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all necessary information to provide you with the best possible care.
Please make sure to bring the following items to each visit:
- A picture ID
- All insurance information.
- All of your current medications including over the counter medications.
We look forward to serving you. Please check in at Suite N