BERRYVILLE MEDICAL ASSOCIATES, PLC
115 South Church Street
Berryville, Virginia 22611
Phone: 540-955-4811
Fax: 540-955-0976

Hours of Operation
 Monday-Friday 8:30am- 5:00pm
Closed 12:00pm-1:30pm for lunch

Patient Forms 

Notice of Privacy Practices  - Information indicating how your medical information is used and/or disclosed.
Authorization to Release Medical Information  - This form gives Berryville Medical Associates the right to retrieve records from another provider. It can also be used to authorize  Berryville Medical Associates to send your medical records to another provider.
Patient Demographic Sheet- This form includes demographic information, as well as, Authorization for Disclosure of Protected Health Information, and insurance information. 
Health History Form - This form collects information regarding you past medical history and family health history. 
Medicare Wellness Form - This form collects information related to preventive visits for MEDICARE patients
Commonwealth of Virginia School Entrance Health Form -  Virginia School Entrance Exam Form. 
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