• Patient Registration Form

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  • If you have never been seen at the Meridian Group before, have not been here for more than 12 months, or have changed insurance plans, please complete this form to request a first appointment. If you do not already have an appointment, you will be contacted by email or telephone within two business days to let you know what is available. All information is confidential. If you have any questions, call our office at 804-751-8644.

  • Primary Health Information

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    Please review the following documents:



      • HIPAA Privacy Practices and Policies

     

      • Office Policies and Procedures

     

      • Telemedicine services (if used)

     

     

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  • Thank you for completing this form.  If you already have an appointment, please also complete the Adult Intake Questionnaire (for adults) or Child and Adolescent Intake Questionnaire (parent or guardian for minors 17 years old and younger).  

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