If you have booked an appointment, thank you! Here are some pre-office visit items for you:

This form should be printed out, signed, and emailed back to
hearthealthyrd@gmail.com (or take picture(s) and send to 571-314-0173):

• Telehealth consent form
• Patient Acknowledgement and Consent

If you did not fill this out when booking an appointment, you can download this, fill it out, and return to me:

• Registration Form

For your review (no need to print):

• HIPAA (Health Insurance Portability and Accountability Act)