Patient Forms
When preparing for your appointment at Hampton Family Practice, please print and complete the applicable patient forms below and bring them with you to your appointment.
MEDICAL RECORDS
RELEASE
Virginia Code § 32.1-127.1:03 requires that most requests for copies of medical records must be made in writing. Use the following forms to request copies of your medical records
PRIVACY NOTICE
We are committed to protecting the privacy of your protected health information. Our Notice of Privacy Practices serves to explain how we may use and disclose your health information according to the Health Information Portability and Accountability Act (HIPAA).
We retain your health information according to guidelines set forth by the Department of Health and Human Services (HHS) and the State of Virginia. Refer to our Notice of Records Retention for information about how we maintain your previous medical information.
MEDICAL RECORDS RELEASE
Virginia Code § 32.1-127.1:03 requires that most requests for copies of medical records must be made in writing. Use the following forms to request copies of your medical records.
LIVING WILLS AND ADVANCE CARE PLANNING
If you are 18 or older, and mentally competent, then you have the right to make decisions about your medical care. Advanced directives are legal forms that help you make decisions about you future medical care. Sentara Healthcare and the Sentara Center for Healthcare Ethics are offering the community the opportunity to complete their Advance Care Plan (Advance Directive) and register it, free of charge, with our national Advance Directive Registry through the U.S. Living Will Registry. Wherever you go in the United States your Advance Care Plan will be accessible by healthcare professionals when needed to guide your medical care if you are unable to communicate your wishes or make your own decisions.