• 3700 Joseph Siewick Drive, Suite 101, Fairfax, VA 22033
  • (703) 698-1856

Below you will find a list of forms that are available for download. Please feel free to call our office with any questions you may have.

Patient Registration Documents

New Patient Packet
Notice of Privacy Practices
Patient History
Release of Information

Miscellaneous Practice Forms

Medical Records Release Form

Procedure Documents

Vasectomy
Cystoscopy
Prostate Biopsy
Ultrasounds / Uroflow
Rezūm Instructions and Consent

Practice Policies

HIPAA Policy

Instructions on how to complete our patient forms
These forms are designed for you to open in Adobe Acrobat Reader. You need to have a printer available to print, fill and sign a copy of the forms. Click the Adobe image below to download this free software if you don’t already have it installed in your computer.

Patient-centered Care

Fair Oaks Urology is committed to providing compassionate, patient-centered, high-quality care. Through efficient use of office staff and medical technology, we are able to offer exceptional patient care in a comfortable atmosphere. Our highest priority in every decision made is what is best and most convenient for our patients.

Fair Oaks Urology Team