Total Healthcare with a Personalized Touch Serving Hampton Roads since 1991
Total Healthcare with a Personalized TouchServing Hampton Roads since 1991 

Patient Forms

We encourage new patients to utilize our online secure patient portal system. You are able to fill out all of your new patient registration forms via this portal. Once you are directed to the site, click on the FORMS tab and complete the "New Patient Demographics" and "New Patient Medical History" forms. Once complete, click SUBMIT at the bottom of the page and they will be imported directly into your chart. **NOTE: If you do NOT have Medicare as your insurance, you do NOT need to fill out the "Medicare Wellness Check" form.

Please click the below link to be sent to our practice's portal site:

** The Patient Portal will be down from 2am-4am every morning for system maintenance. **


If you are unable to complete the required forms online, please plan to arrive 15 minutes prior to your scheduled appointment time.

All new patients will be required to bring insurance card and a photo identification card. Please make sure you have these with at the time of check-in.

Contact Us Today!

Tidewater Family Medical Care, PC
516 Innovation Drive

Suite 103
Chesapeake, VA 23320

Phone: 757-495-0606

Fax: 757-842-6605