Appointment Information & Patient Forms

What do I need for my appointment?
  • Registration Forms: complete, printed, and signed

  • Insurance card(s)

  • Photo ID (driver's license, passport, military ID, etc.)

  • List of current medications

  • Insurance Referral (if applicable)

  • Any pertinent physician notes, diagnostic tests, lab results, and image

To ensure you are seen on time, please complete and bring the registration forms to your appointment. Our building may be tricky to find, familiarize yourself with the directions to our office before your commute.

24-hour Reschedule/Cancellation/No-Show Policy

Cancellations must be made at least 24-hours prior to your appointment time. 

If you need to cancel or reschedule an appointment for any reason, please call our office immediately. Same-day cancellations and/or failure to show for your appointment will result in a $50 charge.

Patient Registration Forms

Click to download. Includes all the forms below.

Travel Clinic Forms

Click to download. 

  • Registration

  • Release of Information and Payment Authorization

  • Consent and Authorization for Treatment

  • Permission to Disclose Protected Health Information

  • Financial and Payment Policy

  • New Patient Summary Form

Notice of Privacy Practices
Click to download.


Infectious Disease Consultants, PLC

11211 Waples Mill Road, Suite 200

Fairfax, Virginia 22030

Phone: 703-246-9560

Fax:      703-246-9564



Monday-Friday         8:30 a.m. - 5:00 p.m.

Closed for Lunch      12:00 p.m. - 1:00 p.m.

Saturday - Sunday    Closed


© 2020 Infectious Disease Consultants, PLC

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