• Skip to primary navigation
  • Skip to main content
  • Skip to footer
  • Facebook

12 locations in:

  • Maryland
    • Bethesda, MD
    • Chevy Chase, MD
    • Germantown, MD
    • Montgomery Village, MD
    • Shady Grove Road: Rockville, MD
    • Medical Center Office: Rockville, MD
    • Silver Spring, MD
  • Washington DC
    • L Street, Washington DC
    • U Street, Washington DC
    • Woodley Park, Washington DC
  • Virginia
    • Arlington, VA
    • Ashburn, VA
Comprehensive Primary Care

Comprehensive Primary Care

Providing Quality Healthcare for You & Your Family

(301) 869-9776

Appointments Patient Portal Telemed
  • About
  • Our Providers
  • Services
  • Patient Resources
    • Appointments & Scheduling
    • Insurance & Payments
    • Medical Records
    • Medication Refills
    • Patient Forms
    • Patient Portal Policy and Procedures
    • Patient Success Stories
    • Referrals
  • Blog & News
  • Locations

Patient Forms

For your convenience, you may download and print our Patient Forms and complete prior to your appointment. Each form is a PDF document that can be viewed with Adobe Acrobat Reader

Download Adobe Acrobat Reader

For service in Washington, DC, please complete: 

  • Authorization Release of Private Health Information
  • Consent to Obtain External Prescription History
  • Controlled Substance Prescription Agreement
  • Medical Record Release
  • New Patient Registration
  • Notice of Privacy Practices
  • Patient Information Update

For service in Maryland and Virginia, please complete:

  • Authorization Release of Private Health Information
  • Consent to Obtain External Prescription History
  • Controlled Substance Prescription Agreement
  • Medical Record Release
  • New Patient Registration
  • Notice of Privacy Practices
  • Patient Information Update

Footer

(301) 869-9776

Convenient Locations in:

  • Arlington, VA
  • Ashburn, VA
  • Bethesda, MD
  • Chevy Chase, MD
  • Germantown, MD
  • Montgomery Village, MD
  • Rockville, MD
  • Medical Center, Rockville
  • Silver Spring, MD
  • U-Street, DC
  • Woodley Park, DC
  • L Street DC
Appointments Patient Portal Access your health records on your phone! Telemed Careers

Email Newsletter

Your email address is safe with us. We send emails only a couple of times a year.

  • This field is for validation purposes and should be left unchanged.
  • Facebook

© Copyright 2015 Comprehensive Primary Care. All Rights Reserved.

Website SEO and Marketing by MarketSpark Digital Marketing • Admin

In memory of Dr. Visha Dinesh

With deep sadness, we announce the sudden passing of our dear colleague Visha Dinesh, MD. She was an exceptional physician, beloved by her patients and staff. She will be forever missed.

To her patients: Please contact the Chevy Chase office so that we can ensure continuity of care.