Online Forms

Surgical Associates of Fredericksburg is pleased you have chosen our practice to provide care to you or a family member. In order to provide care and ensure accurate documentation, we will need to obtain personal and health information at the time of the first visit.

Please click on the links below for copies of the patient information forms that are necessary for your first visit to Surgical Associates of Fredericksburg. You may download the forms, print and complete them. If forms are completed more than three days prior to your scheduled appointment, please mail (4548 Empire Court, Fredericksburg, VA 22408) or fax (540-371-4849) forms to the office; otherwise, please bring with you on your first visit to the office.

New Patient Forms (General)
Download this set of forms if you are a new patient seeing SAF for general services.

New Patient Forms (Breast Problems)
Download this set of forms if you are a new patient seeing SAF for breast problems.

New Patient Forms (Colon & Rectal Problems)
Download this set of forms if you are a new patient seeing SAF for colon and/or rectal probems.

Patient Registration Form
Download if individual registration form is needed. This form is included in above downloads.

Health History Form
Download if individual health history form is needed.

SAF Privacy Form
Download if individual privacy form is needed.

Breast Health History Form
All first time breast patients should complete this form.

Colon and Rectal Health History Form
All first time colon and rectal patients should complete this form.

Medical Records Release Form

Minor Office Surgery Form

Dressing Change Instructions Form