Contact Us
Phone: (703) 941-0267
Referrals: ext. 194
Billing: ext. 291
Fax: (703) 941-2018
E-Mail
Referrals, Refills, Cancellations and Billing
Referrals: referrals@afmed.com
Please leave the following information:
Patient's Name:
Doctor's Name:
Patient's Date of Birth:
Your Contact Phone Number:
Insurance and Policy Number:
Referral Doctor:
Referral Reason:
Refills: refills@afmed.com
Please leave the following information:
Patient's Name:
Patient's Date of Birth:
Your Contact Phone Number:
Doctor's Name:
Medication Name:
Pharmacy Name:
Pharmacy Location:
Pharmacy Phone Number:
Cancellations: cancellations@afmed.com
There will a be $50 no-show fee for a 15 minute appointment and a $100
no-show fee for a 30 minute appointment for not canceling your appointment
within 12 hours of your appointment time.
Please leave the following information:
Patient's Name:
Time and Date of Appointment:
Doctor's Name:
Billing: billing@afmed.com
Doctors and Nurse Practitioners
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