Become a Patient

Getting Started

An appointment for a consultation must be made so our doctors can examine you and determine the nature of your problem and their suggested resolution. To make an appointment, please call our appointment line at 301.251.4128, option 2 for Advanced Surgery, then option 1 for appointments.

We see patients Monday through Friday at a variety of convenient times in our Rockville location. Please have your insurance card handy when calling for an appointment. A list of participating insurance companies is listed under the Insurance & Fees tab.

To expedite your initial appointment with us, we request you fill out our online Patient Forms and bring them with you to your appointment. The other forms are provided for your information.

You may be asked to update these forms once a year so we can be compliant. Please click the link below to fill out our online Patient Registration Form, Health History Form and our Disclaimer. Then print these out and bring them, along with your insurance card and a picture ID at the time of your appointment.

New Patient Packet

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. Autorización De HIPAA Para Divulgar Información Del Paciente

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