Augusta Health Care for Women

39 Beam Lane,Fishersville, Virginia 22939
Phone: (540) 213-7750, (540) 213-7755

110 Houston Street, Suite C, Lexington, Virginia 24450
Phone: (540) 463-7751, Fax: (540) 213-7755.


Patient Forms

Pre-Register via  the Patient Portal

We encourage all patients to pre-register for your appointment via our secure, online patient portal.  You can arrive 5-10 minutes prior to your scheduled appoinment since most of the administrative and clinical intake will be completed prior to your arrival.


Medical Records Request/FMLA or Disability Forms

If you are transferring your care to Augusta Health Care for Women, we ask that you request the past 3 years of your medical record from your previous health care provider. Click the link below:

Medical Records Release

Please complete the form and fax it to our office at 540-213-7755 or you may submit it to your previous health care provider for processing. Records can take up to 30 days to be received, please submit this form as soon as possible.

FMLA or Disability Form Completion

If you will require FMLA or Disability paperwork to be completed, please complete our request form and return it along with your employer or insurance company  form to our office. Please note: It can take up to 2 weeks for forms to be processed. Please note: The processing fee of $20 (per form) must  be paid at the time you submit the forms for us to process them.

FMLA Records Request