Your Appointment

To schedule or change an appointment, please call (804) 276-2470 during regular working hours.

We participate with Anthem Blue Cross/Blue Shield, Southern Health, Virginia Health Network, Aetna, Optima Health, Cigna, Multiplan Networks, and Medicare. We do not accept HMO's. If we do not accept your insurance, full payment is due at the time of service. As a courtesy, our billing department will submit your claim to your insurance company. The insurance company will reimburse you directly according to your out of network benefits.

Prior to your first appointment, you will need to complete the three attached new patient forms. In order to expedite your registration, please access the forms below and bring the completed forms with you to your first office visit. All forms must be completed prior to seeing the physician. If you are unable to print a copy of these forms, please arrive thirty minutes prior to your appointment time to complete the new registration forms.

Please bring a copy of your insurance card to all office visits and notify the front desk staff of any insurance or address changes.

HIPAA stands for the Health Insurance Portability and Accountability Act. The HIPAA Privacy Rules establish detailed requirements for the use and disclosure of an individual's protected health information by health organizations and health providers. For additional information on this Act, established in April 2003, please review the attached HIPAA handout and sign the HIPAA acknowledgement form.

1. Patient Registration Form (Adobe PDF Format)
2. H&P Form (Adobe PDF Format)
3. HIPPA Notice (HTML Format) or (Adobe PDF Format)
4. HIPPA Acknowledgment Form (Adobe PDF Format)


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Amberleigh Medical Center | 9460 Amberdale Drive, Suite C | Richmond, VA 23236 | PHONE (804) 276-2470 | FAX (804) 276-2473