Thank you for choosing Virginia Heart. If you are a new patient, please follow the instructions below to register online before your first appointment.

New Patient Forms

Please complete the two forms below at least 48 hours or 2 business days before your appointment in order to streamline your first office visit if you are:

  • A new patient
  • A patient who has not been seen by one of our providers in the past two years

Click on the selections below to fill out the forms. When you are finished with each form click "Submit" to send it to us electronically.

Patient Registration  Patient Health History

These patient forms are secure. Your information will be kept confidential and will be viewed only by your doctor and our practice staff. For the best experience please complete the patient registration forms on a desktop computer or larger device such as a tablet.

NOTE: If your new patient appointment is scheduled less than 48 hours from the appointment time, please print out the forms below and complete them prior to your appointment. Please bring the completed forms with you and arrive 15 minutes early for your appointment.

If for any reason, our online forms have a technical issue you may print out the two required blank patient registration forms below to complete prior to your appointment. 

Patient Health History Form

Patient Registration Form

STOP BANG Questionnaire

Patient Health History Form (Spanish)

Patient Health History Form (Chinese)