- Please arrive promptly and allow 20 minutes to update/complete the required paperwork.
- You must bring your insurance card and driver's license (or other legal picture id).
- New patients will need to complete medical history, registration, and HIPAA forms
- All patients will need to complete the registration form once a year.
- For Managed Care insured: Please bring the necessary referral form from your primary care physician at the time of your visit.
Emergencies: Obstetrics and Gynecology often involves emergency procedures, surgical delays, and deliveries. We ask for your understanding, and if we are running behind schedule, our staff may attempt to notify you.
Cancellations: We also request that you arrive promptly for your visit. If you are unable to keep your appointment or are going to be late, please call the office as soon as possible. Please provide a 24 hr notice for cancellation or rescheduled appointments. Missed appointments may result in a $50 fee.
You can print the following forms out as needed, complete them at home, and bring them with you to save some time on the day of your appointment:
Patient Registration form (PDF)
New Patient History Form #1 ( PDF)
New Patient History Form #2 ( PDF)
Use & Disclosure:
Hipaa Pg1 PDF
Hipaa Pg2 PDF
Emergency Care and After Hours
Physician coverage is available 24 hours a day.
If you have an emergency, call our office anytime, day or night, and explain the urgency of your call. Our doctors will be notified immediately and will return your call.
All patients are encouraged to call with any questions they have regarding their health care.If the doctor is unavailable, please provide our staff with as much information as possible regarding the nature of your call.
If you have an emergency, notify the receptionist and your doctor will be contacted immediately.
Our office will make every effort to contact you with lab or x-ray results. In the event of abnormal lab results, we will call you promptly.
If you would like a copy of your results, ask on your next visit or pick it up at the office. Please help us keep you informed by keeping our records updated with current information for your address, phone number and insurance coverage.
Obstetrical and Surgical
If your pregnancy is covered by insurance, at the time of your initial visit we will discuss payment plans with you. This payment plan will meet the portion of your care that is not covered by insurance. We request that this portion is paid in full by the 7Th month of the pregnancy.
Our doctors see patients at Alexandria Hospital.
Rounds are made at least once daily and more frequently if necessary. Please feel free to ask any questions you may have when we make rounds. We will also be happy to speak with family members if the patient so desires.
You must arrive at the hospital at least 2 hours prior to your scheduled surgery time. Your Surgery Coordinator will call you with this time one day prior to your surgery date. See the full instructions>>
Please request all prescriptions and authorizations for renewals during office hours. Renewals requested at other times will be filled only for an emergency situation.
Please leave your pharmacy telephone number and any prescription available so we may expedite your request.
- Prescription refills will be processed only for ESTABLISHED PATIENTS who have been seen within the past 12 months.
- Your chart will be reviewed by your physician and the refill will be called in directly to your pharmacy, within 24 hours of receipt, on the next business day. If your physician feels an office visit is necessary before a refill can be given, you will be notified by phone.
- One additional month of refill birth control pills can be called in for established patients. This will allow time to schedule an annual visit.
Authorization to Release Medical Records
OB/Gyn Associates of Northern Virginia maintains the patient's rights that all medical records are kept confidential according to all federal and state laws.
Federal and State law requires the patient's signature, or that of an authorized personal representative, to release or transfer medical records. The patient records are defined as all records that relate to the health of the patient and are prepared by or under supervision of a health care provider associated with OB/Gyn Associates
of Northern Virginia.
Patients that provide records from another physician, outside of OBGYNNOVA, are encouraged to retain their own copy as we cannot provide a copy.
Please click below to print the applicable form:
Records Release TO OBGYNNOVA
Records Release FROM OBGYNNOVA
Insurance & Billing
Insurance and Payment Information
We encourage all patients to confirm their coverage prior to making an appointment. We accept most major Insurance plans. Co-payments are due at the time of the appointment. You are responsible for any unpaid balance not covered by insurance. Please call us with any questions regarding which insurance plans we accept or other billing concerns. Insurance coverage and benefit questions should be directed to your health insurance provider.