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Tim Shepherd, MD

Family Practice

Proudly Part of Privia Health

Become a New Patient

We are currently accepting new patients into our practice. Thank you for considering us.

When you come to our office for the first time as a new patient, we'll ask you to complete some initial forms, including an Authorization and Consent for Treatment form, if you were not able to download them from the patient portal in advance of your appointment.

To make sure there are no delays in care during your first visit experience, please arrive 15 minutes prior to your scheduled appointment to ensure your registration is complete before meeting with your new provider.

Remember to bring:

  • Your insurance card
  • Valid photo ID
  • List of current medications
  • Office co-pay

In an effort to respect the time of all of patients, our staff strives to stay on schedule so that other patients do not have to wait.

For patients who are delayed and arrive late for appointment, every effort will be made to see them the same day. However, wait times may apply, or appointments may need to be rescheduled.

New Patient Paperwork – To expedite your appointment check-in, please fill out pages 1-9 in their entirety, and bring them with you to your appointment along with your drivers license and insurance card. The Financial Policy, found below, is for your own records. Please read it thoroughly.

Patient Forms

Patient Registration (PDF) - All patients should fill out this form to register with us.

Consent for Treatment (PDF) - All patients must provide their consent for treatment. Autorización y Consentimiento Para el Tratamiento.

Patient Record of Disclosures (PDF) - Gives patients the ability to request the uses and disclosures of their protected health information (PHI).

Release of Patient Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. HIPAA Autorización para la divulgación de información de salud del paciente.

Notice of Privacy Practices (PDF) - This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Office Policies

Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)

Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)

HIPAA Privacy Notice