Inova Primary Care - Falls Church Patient Resources | Inova

Forms for all patients

Medical Release Forms

Release of medical information form
(To ask Inova to release your medical records to another doctor's office)
Standard medical record release
(To ask another doctor's office to release your records to Inova)

Primary Care Patients – Medical History Form

This form should be completed by all new patients who are seeing an Inova Primary Care provider.

Medical Condition and History Form

Specialty Care

Our specialty care offices will often have additional forms specific to their practice that they will ask you to complete. Please refer to the online content for your specialty physician's practice to see if other forms may also be requested.

Health plans accepted

EPO
HMO
Managed Medicaid
Medicare Advantage
POS
PPO

Exchange
FEP
HMO
Indemnity
Managed Medicaid
Medicare Advantage
POS
PPO

Beacon Health Options (formerly Value Options) – terminated 9/30/2023
Evernorth Behavioral Health (formerly Cigna Behavioral Health)
Molina Complete Care Behavioral Health (formerly Magellan Behavioral Health)
Optum Behavioral Health (United)

BlueChoice
Exchange
FEP
HMO
Indemnity
POS
PPO

Exchange
HMO
Medicare Advantage
POS
PPO

Anthem
Carefirst
Cigna
Innovation Health
Optima
Oscar Health
Sentara Health Plan
United Healthcare

Exchange
HMO
POS
PPO

We accept the US Family Health Plan but not the other Johns Hopkins plans

Kaiser is only accepted at Inova Fair Oaks Hospital for Obstetrics (OB) services only
Medicare Advantage at Inova Hospitals only

Aetna Better Health of Virginia
Anthem HealthKeepers Plus
Molina Complete Care
Optima Health Family/Optima Health Community Care
United Healthcare Community Care
Virginia Premier Elite

PPO

Medicare Part A: Hospital services
Medicare Part B: Physician services

Aetna Medicare Advantage
Anthem Medicare Advantage
Cigna Medicare Advantage
Humana Medicare Advantage
LifeWorks Medicare Advantage
Molina Medicare Advantage
Sentara Health Plans Medicare Advantage
United Healthcare Medicare Advantage

* Always check with your insurance provider to verify that Inova is in-network for your plan and for details on your individual level of coverage.

Multiplan/PHCS

Exchange

Exchange
HMO
POS
PPO
Medicare Advantage
Managed Medicaid

Tricare for Life
Tricare Prime
Tricare Select

Exchange
HMO
Managed Medicaid
Medicare Advantage
POS
PPO
VA-CCN

Virginia Medicaid