Forms and Policies

The following forms and policies will need to be reviewed and completed before your first visit. To make sure there are no delays in care during your first visit experience, please arrive 15 minutes prior to your scheduled appointment to ensure your registration is complete before meeting with your new provider. 

New Patient Request Form

Authorization for Release of Medical Information

Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.

Authorization and Consent for Treatment

All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.

Preferred Contacts

Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.

Virtual Visit Policy

This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.

Financial Policy

This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.

Notice of Privacy Practices

Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.

HIPAA Privacy Notice


  • Just remember to bring:

  • Completed forms

  • Your insurance card

  • Valid photo ID

  • List of current medications

  • Office co-pay


CVFP Medical Group Administration

1111 Corporate Park Drive, Suite D
Forest, VA 24551

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We work hard to help people attain better health for a better life. We serve our patients by delivering high quality, cost-effective healthcare services while also providing a great patient experience.

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