New Patient Registration & Forms

Please find our easily accessible forms below for your benefit as a patient. All forms are printer friendly for your convenience to make your appointment run more efficiently at Apex-MD.


Please complete the following online form below to request a new patient appointment:

Please read, fill, print, sign and bring or email (This email address is being protected from spambots. You need JavaScript enabled to view it.) the following document:

You can also download all the forms separately by clicking on the links below:

School Forms

Apex MD's policy related to completing school forms:

Patients requiring a form completed by our office for school, camp, sports, pre-school, medication administration forms, or any other form that requires a physician's signature, if brought in conjunction with your child's well/physical exam visit, the office will complete the form at no additional cost to the parent. Please ensure that you complete all components of that form prior to your child's arrival at our office. Apex MD encourages parents to bring the form with them as we may not have the most up to date required form for your child at hand.

Should the necessary forms not be presented by the parent at the time of your child's well/ physical exam visit and it is brought in or mailed to our office for completion after their well/physical exam visit, you will be subjected to a $5.00 administrative fee for each form/each child that will be due upon Apex MD's completion of that form. If you are requesting that our office mail your child's form back, you will need to send payment along with that form. Please be aware that this $5.00 fee is not covered by your medical insurance policy.

What We Treat

We Treat ALL Primary/Urgent and Chronic Medical Conditions and provide Comprehensive Care for your whole family – patients of all ages – Pediatrics, Teens, Adults

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Our Location

5310 Twin Hickory Rd, Suite A
Glen Allen
VA 23059

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