For your convenience, we have the following New Patient Forms for you to print out and complete for your first visit, or you may fill in the forms and e-mail them to womenscareofarl@aol.com :

Demographics Form

Financial Policy

Patient Responsibility

If another doctor has confirmed you as being pregnant, please complete the additional form as well:

Obstetric History



Obstetrics Pre-Admin Form for Virginia Hospital Center


Records Request Forms:

To Women's Care of Arlington from another healthcare provider

From Women's Care of Arlington to another healthcare provider


Reference Materials:

HIPAA Notice Of Privacy Practice



Women's Care of Arlington, PLLC