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OBGYN Obstetrics Gynecology Office Virginia Beach, VA
Patient Forms
Dr. Richard Valentine OBGYN Medical Practice

Patients are required to complete a few of the following forms before being seen in our office. You can save time by downloading the appropriate form before your visit and completing it in black ink at your convenience before you arrive. If you forget to bring your completed forms to your appointment, please allow at least 15 minutes to re-do this paperwork.

If you are NOT PREGNANT and coming for your very first visit with us, please complete forms 1, 2, and 3.

If you are PREGNANT and coming for your first visit this pregnancy (whether you are new to the practice or a repeat customer), please complete forms 1, 2, and 4

Recent updates to laws governing your privacy and security state that provision of your social security number on any of the following forms is not necessary.
Please leave any spaces requesting SS# blank.

Patient History 'Before You Arrive' 1. Patient Information
Notification of Privacy Practice 2. Notice of Privacy Practices
After reading the entire form, print and complete page two.
Admission Form 3. Patient History
Pre-Natal History 4. Prenatal History
Admission Form 5. Admission Form
Pre-registration to Sentara Leigh Hospital for our pregnant patients
Forms are viewable in Adobe Portable Document Format (PDF). Download the Adobe PDF reader. Get the latest updates available for your version of Adobe® Reader®.
"We treat you like friends and care for you like family"
Women's Forum
Do you have questions or concerns regarding pregnancy, breastfeeding, female issues, parenting or other specific OB/GYN concerns? Post your question here or offer words of wisdom as women help women find the answers.
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Share Your Birth Story
We think childbirth is an amazing experience, no matter how your newborn arrives into the world. One of the best ways for moms-to-be to prepare for their own births is to hear positive stories from the real experts: other moms.
Birth Stories
Centering Pregnancy - Model for group prenatal care
Centering Pregnancy®
A model for group prenatal care, an empowering program for clients and professionals
Richard N. Valentine, Jr. M.D., P.C. 700 Independence Circle #3A Virginia Beach, VA 23455
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