Sachem Office 1450 Sachem Place Suite 202 Charlottesville, VA 22901 (434) 978-4090 Office (434) 978-1005 Fax Request an Appointment Please download, print, and review these forms before arriving for your appointment. PATIENT REGISTRATION BILLING POLICIES NOTICE OF PRIVACY PRACTICES CONSENT FOR USE AND DISCLOSURE OF HEALTH INFORMATION   Pantops Office 600 Peter Jefferson Parkway Suite 390 Charlottesville, VA 22911 (434) 975-2420 Office (434) 979-0500 Fax Request an Appointment Please download, print, and review these forms before arriving for your appointment. PATIENT REGISTRATION BILLING POLICIES NOTICE OF PRIVACY PRACTICES CONSENT FOR USE AND DISCLOSURE OF HEALTH INFORMATION Office Hours Monday - Friday 8:30 am - 5:00 pm

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