Growth and Development Forms
Preventative/Annual Health Exam (PME)

Medical History for PME 9. 2018

School and Sports Forms
Medical Records Release Forms

Medical Records Release from FMOA

Medical Records Release to FMOA

Privacy Notice Forms
FMOA Financial Policy

Patient Financial Policy


    Family Medicine of Albemarle would like to inform you of some of our billing practices to help you manage your money wisely.

    Your coverage is a relationship directly between you and your insurance company. We are not able to answer questions about what your individual policy will cover.

    If you have questions about tests, exams, co-insurance, copays and summary of benefits, please contact your insurance company directly.

    If you pay in cash or are a self- pay patient, FMOA requests that you provide a $50 copay at the time of check in. Please be prepared to pay for your visit in full or provide a credit to be placed on file.

    There is discount for self-pay if the full bill is paid at the time of service.

    Physicians are on-call and can answer your questions. If they provide you care via the phone, they may bill you for their time and expertise if a following visit is not scheduled in the office.

    Labs: tests may be ordered during a preventive exam that your insurance company will not cover in full but are important for your care. Prior to ordering these labs we will discuss them with you.

    Need a school/camp/sports physical? Give us a call and schedule one today at 434-973-9744