MFC / YOUR INFORMATION MATTERS

Privacy & patient forms

Patient privacy notices, downloadable paperwork, and how this website works.

Hands-on assessment of a patient’s back
PERSONAL CARE. LOCAL ROOTS.
Read the patient privacy notice (PDF)

READY WHEN YOU ARE

Paperwork, made easier.

YOUR NEXT STEP

Bring it to your first visit.

  1. Download your preferred format and complete the fields on your device.
  2. Save your completed copy and reopen it to check that your answers are there.
  3. Print your completed paperwork and bring it to your appointment. The office can confirm any required signatures.
Questions? Call the office

Need help with your paperwork? Our team can help you prepare for your visit.

The patient privacy notice

The practice's Notice of Privacy Practices describes how it handles protected health information in patient care. Use the patient privacy notice PDF link, or call the office for a copy. This patient notice is separate from the information about this website.

Your paperwork stays on your device

This website provides blank PDF and Word downloads. It does not ask you to upload or email completed forms, and it has no online medical intake or contact submission service. Complete and save your copy on your own device, print it, and bring it to your appointment.

Website features and hosting

No visitor analytics, advertising trackers or website-set cookies are installed in this build. Its resource search runs in your browser. The hosting service may handle technical request information; its logging and retention settings have not been confirmed for the clinic's final host. The practice should confirm those details before public launch.

External websites

Directions, Google reviews, social profiles and educational references link to other websites. Their own privacy practices apply when you open them. These services are links rather than embedded maps or review feeds.

Questions about your care or records

Call (804) 608-3045 for appointments, records or patient privacy questions. Do not use this website as a way to send medical information.

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