New Patient Forms

Please bring these 3 completed forms to your 1st appointment with us.

Patient Registration
Medical History
Financial Policy

Other forms that may be helpful during your visit:

Dizziness Questionnaire - If you are coming to see us for dizziness, imbalance, lightheadedness concerns
Head Nose - If you are coming to see us for hearing issues and Tinnitus
Epley Maneuver
Notice of Privacy Practices - Our HIPAA policy
Request Medical Records

For convenience you are welcome to fax your completed forms to us at 804-282-1043. We just ask that you please fax them at least 48 hours prior to your visit.

Post-Operative Instructions

Ear Tube Placement
Tonsillectomy/Adenoidectomy Post Op & Diet Instructions
ALL Ear Surgeries (excluding Ear Tubes)
Neurotologic Patients
Labyrinthectomy and Endolymphatic Sac Surgeries
Cochlear Implants
Nasal Surgery
VIVAER Procedure



Virginia Hearing Center

Balance and Ear Center

Pediatric Center

Priority Physician Referral

Patient Portal

Pay Online

Office Hours

Monday: 7:30 am - 5:00 pm
Tuesday: 8:30 am - 5:00 pm
Wednesday: 8:30 am - 5:00 pm
Thursday: 8:30 am - 5:00 pm
Friday: 7:30 am - 2:30 pm

Main Phone Line:

Virginia Hearing Center:


Phones turned over to voicemail 30 minutes prior to office closing.

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