New Patient Forms
Please click here to download & print the "New Patient Form". Bring the completed form to your appointment. If you don't have time to do it prior to your arrival, please arrive 20-30 minutes before your appointment so you may complete them. This will allow more time to discuss your clinical concerns.
We are committed to putting your health and safety first. To limit your time and exposure in our office, you will be asked to complete your New Patient Paperwork on our secure patient portal through Azalea Health prior to your arrival. Should you have questions about gaining access, please contact our office at 757-389-5505.
To maintain social distancing guidelines per CDC recommendations:
- If you've traveled internationally within the last month, been ill with a fever or had recent exposure to anyone with COVID-19, please contact our office to reschedule your appointment.
- We will limit the number of people in our waiting area to maintain social distancing practices. We ask that you NOT bring visitors with you. Should there be extenuating circumstances that require the presence of another person, please contact our office to discuss your need.
- Our staff will be wearing masks and it is expected that all who enter our clinic wear a mask as well.
- You will be asked a series of questions when you arrive to the office and your temperature will be taken.
- In addition to wearing masks, frequent hand washing with soap and water and use of disinfectants and sanitizers for all surfaces will be performed on a regular basis per CDC.gov guidelines.
For more information from the CDC, please
Pay Balance Online
To pay your bill online, be sure we have your email address and your patient portal has been set up. If that has not been done, please contact our office at 757-389-5505.
Once that is complete, follow the instructions below:
1. Go to
app.azaleahealth.com and login.
2. Your dashboard will be the next screen and on the right side you will see your "Patient Balance". Click the "Pay Now" button.
3. The next screen will have a button at the top: "Pay Online with Card Connect". A pop-up box will appear for you to enter your card information.
4. Be sure to print your receipt for your records.
If there are any issues, please feel free to contact our office at 757-389-5505.