Now accepting Telehealth appointments. Schedule a virtual visit.
Skip to main content

Appointment Forms


person writing

Here at Washington Internal Medicine, we are always accepting new patients. Regardless of whether you are sick or are simply due for a regular check-up, we are happy to welcome you to our office. We know going to the doctor can be a little overwhelming at times, so we are happy to provide you with our new patient forms ahead of time so that you can fill them out prior to your appointment and save you time during your visit. Remember to bring a list of any medications you may currently be taking as well as any previous medical records you may want to provide. Our mission is to provide quality care to our patients, and we are happy to help you in any way we can. For more information or to request an appointment, contact us today at (703) 436-9969.

Check-In Forms

We have made our office forms online available for the convenience of our patients. To shorten the duration of check-in we ask our patient to complete the Check-In Form before the appointment. You may have also received the Check-In Forms electronically in your email during appointment confirmation. If you are a ZocDoc user, you may receive pre-check in forms on your mobile or email ahead of your appointment. If you are ready to complete your form now please click on the button below and fill in the pre-check in paperwork and email us a copy of your Photo ID at or text us a photo to (703) 436-9969

Online Forms

COVID-19 Screening Form

Check-in Form

Payment Policy Form

HIPAA Consent Form

Medical Record Release Form

Please be sure to bring results of recent hospital discharge paperwork, labs/diagnostic studies, medications bottles or any other relevant medication information with you to the office for the doctor to review.

If you do not have AdobeReader® installed on your computer, Click Here To Download.

Our Locations

Choose your preferred location