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Virginia Beach, Virginia
Downloadable Forms

This page allows you to download several of our office forms below. These forms are all in the PDF format and will open in a new window. If you do not have Adobe Reader installed on your computer, you may download it directly from Adobe at no cost. Thank you for taking advantage of our online service.

  • » Health History « (This form provides Dr. George with your prior medical history including any allergic reactions to medicines, health problems, or prior medical procedures.)
  • » Patient Data Sheet « (This form provides basic information about you, an emergency contact, and your billing agreement and notice of deemed consent.)
  • » Release Form for Protected Health Information « (Download this form and send it to your physician to request that your previous medical records be released to our office; note that most facilities charge a modest fee for retrieving and copying your records.)