Become a Patient

Whether you are new to the area or currently are not established with a primary care provider, look no further! Mount Vernon Internal Medicine has highly qualified Physicians and Nurse Practitioners who are available to help.

Please review the provider photos and biographies on our Meet the Team page.

If you have questions please contact our call center representatives for guidance on which provider is the best fit for you at 703.780.2800.

ITEMS TO BRING TO YOUR FIRST APPOINTMENT:

1. Your current Insurance Card and a valid Photo ID. We follow very strict privacy guidelines. In order to protect our patient’s identity and prevent fraud, we require both of these at the time of your appointment.

2. Completed Care Visit Form which will include:
– A list of providers/specialists from whom you receive care.
– A list of your medications and their dosages; both over the counter and prescribed.
– A list of your previous surgeries or conditions that you have received treatment for.

3. Your vaccination record.

4. Completed New Patient Questionnaire Form.

Please arrive 15 minutes prior to your scheduled appointment time to allow us time to verify your information and fill out any necessary paperwork. To provide top notch care, we like to know who our patients are and to be able to fulfill this, we will ask you about your family history and other vital background information during your first appointment.

** If you have a HMO insurance and another provider’s name is listed as your PCP on your card please call your insurance company to have this changed before coming in for your appointment. Unfortunately, insurance companies do not allow us to make this change on your behalf.

** If you are receiving care due to an injury covered by a Workman’s Compensation Insurance, please note, you must contact your case worker before your appointment and receive authorization to see us. We will need your claim number, authorization number, case worker’s contact information and the name, address and phone number of the Insurance Carrier.


Our providers will be delighted to fill out any medical forms for patients. However, in order to do this, ample time must be given. It will take approximately one to two business days for the forms to be completed. You will need to let us know how you would like to receive your medical forms. Please see the Authorization For Release Of Medical Information form below for more information.

Become a New Patient

We are currently accepting new patients into our practice. Thank you for considering us. To become a new patient:

  1. Make an Appointment
  2. Sign up for our patient portal
  3. Download your patient forms online through the patient portal

When you come to our office for the first time as a new patient, we'll ask you to complete some initial forms, including an Authorization and Consent for Treatment form, if you were not able to download them from the patient portal in advance of your appointment.

To make sure there are no delays in care during your first visit experience, please arrive 15 minutes prior to your scheduled appointment to ensure your registration is complete before meeting with your new provider.

Remember to bring:

  • Your insurance card
  • Valid photo ID
  • List of current medications
  • Office co-pay

In an effort to respect the time of all of patients, our staff strives to stay on schedule so that other patients do not have to wait.

For patients who are delayed and arrive late for appointment, every effort will be made to see them the same day. However, wait times may apply, or appointments may need to be rescheduled.

Patient Forms

Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.

Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento

Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos

Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.

Office Policies

Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.

Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.

HIPAA Privacy Notice