Patient Information and Forms

Patient Information and Forms2024-07-24T20:56:01+00:00

Patient Registration, Forms, and Policies

Please find patient registration forms, our office and cancellation policies, health insurance information, and more. Please call our office if you are unable to find the information you need.

Patient Registration and Forms

New Patient Registration2024-10-15T22:25:16+00:00

I’m a new patient, how do I prepare for my first appointment?

Thank you for choosing Elite Gynecology and Wellness, we are excited to have you as a new patient!

In order to ensure a smooth initial visit, please complete all fields on the secure patient registration link that will be sent to your email and/or via text from Elite Gynecology and Wellness. We ask new patients to arrive 30 minutes prior to your scheduled appointment time. Please bring the following to your appointment:

  • Insurance card(s)
  • Photo ID
  • Cash or credit card for your insurance copay (if applicable)
  • Current medication list
  • Surgical history
  • Medical records from your prior OB/GYN facility and/or hospital
  • Questions for your provider

If you have any questions, or have not received an email or text with the patient registration link, please call our office at 540-374-7020. We look forward to seeing you soon!

Established Patients2024-10-15T22:25:01+00:00

I’m an established patient, what do I need to bring to my appointment?

Thank you for choosing to continue your care with Elite Gynecology and Wellness! Prior to your visit you will receive an email and/or text message with a secure patient registration link. If you have not received this email and/or text, please give us a call prior to your appointment. For every visit, please be sure and bring:

  • Your current insurance card(s)
  • Photo ID
  • Cash or credit card for insurance copayment (if applicable)
  • Medical records if following up from another facility or hospital
Medical Records Requests2024-10-15T22:25:50+00:00

How can I get copies of my medical records?

Elite Gynecology and Wellness is happy to accommodate all medical records requests. In order to process your request, please complete and return the Medical Records Release Form to pgagnon@egwva.com or fax to 540-374-7030 and allow up to 14 days for records to be sent.

A $10 fee is required for records to be burned onto disk. Printed records are $0.50 for the first 50 pages.

Health Insurance2024-10-15T22:24:30+00:00

We currently accept the following health insurance plans:

  • Aetna
  • Anthem BlueCross BlueShield
  • CareFirst BlueCross BlueShield
  • Cigna
  • * Unfortunately, Elite Gynecology and Wellness is unable to process Medicare or Medicare replacement plan claims. We apologize for the inconvenience.
What is your process for FMLA/Short Term Disability paperwork?2024-10-15T22:26:08+00:00

What is your process for FMLA/Short Term Disability paperwork?

Elite Gynecology and Wellness charges a $25 fee for all FMLA or short term disability form processing. Please allow 1-2 weeks for forms to be processed. Fee must be paid upon completion or when forms are given to the front desk. Thank you for your understanding.

Appointment Policies

No Show or Missed Appointment Policy2024-10-15T22:25:32+00:00

What is your “no show” or missed appointment policy?

We make every effort to remind you of your scheduled appointment via text message and/or email, so please be sure that we have your correct cell phone and/or email address on file so you do not miss the reminder messages. Please note that we do not call for appointment reminders.

Our office requires a 24-hour notice to cancel or reschedule an appointment. At Elite Women’s Health, we make every effort to schedule your appointment in a timely fashion, while ensuring the appointment length allows time for you to discuss your medical concerns with your provider. A last-minute cancellation or missed appointment will not only delay your care but also prevents us from rescheduling another patient who could have been seen at that time.

We do understand that sometimes unforeseen emergency situations arise; however, we ask that you provide us with the courtesy of canceling or rescheduling your appointment at least 24 hours prior to your scheduled appointment.
Please be aware that we charge $50for each appointment that is missed or rescheduled with less than 24 hours notice. After three last-minute rescheduled or missed appointments we may choose to discontinue your care.
Late Arrival Appointment Policy2024-10-15T22:23:00+00:00

What is your policy if I’m running late for my appointment?

We respect the time of all our patients, and our providers strive to stay on schedule and see patients as close to their scheduled appointment time as possible.  If you are delayed and arrive late for your appointment, every effort will be made to see you the same day. We ask that if you are running late, please give the office a courtesy call to let the front desk know. Unfortunately, if you are more than 15 minutes late for your appointment, you may be asked to reschedule.

If you are a new patient and do not arrive 15-30 minutes prior to your scheduled appointment time, you may be asked to reschedule as it takes 15-30 minutes to complete the new patient registration process. We appreciate your understanding.

Appointment Cancellation Policy2024-10-15T22:23:25+00:00

What is your appointment cancellation policy?

We ask that you provide a 24-48 hour notice to cancel or reschedule your appointment. A last-minute cancellation or missed appointment will not only delay your care but also prevents us from rescheduling another patient who could have been seen at that time.

Please be aware that we charge $50 for each appointment that is missed or rescheduled with less than 24 hours notice.

Medical Questions

Medical Emergencies2024-10-15T22:24:10+00:00

What should I do if I have a medical emergency?

If you have a life threatening emergency, call 911. For other non life-threatening emergencies:

During Regular Business Hours:

Call 540-374-7020 and choose the prompt to speak to the front desk so they can route your call to a nurse for help.

After Regular Business Hours:

Please call 911 or visit your nearest hospital.

Prescription Refills2024-10-15T22:23:49+00:00

How can I get my prescription refilled?

Please call the office to request a prescription refill and allow 24-48 hours for your refill to be processed and then check with your pharmacy. For birth control refills, please be sure you have a current annual exam or have been seen recently or we will not be able to process your refill request.

Non-urgent medical questions for nurses2024-10-15T22:23:37+00:00

When will a nurse call me back for a non-urgent issue?

When a non-urgent message is left on a nurse’s voicemail, the patient will receive a call back by the end of that business day.

We Look Forward To Your Visit

Our office hours are Monday – Friday, 8AM – 4:30PM. We are accepting new patients and excited to provide the highest-quality gynecology, gynecologic surgery and women’s health and wellness services to our community.

Go to Top