New Patient Information

Starting care with a new medical team can come with questions about what to complete, what to bring, and what your first appointment will be like. We want you to feel prepared before you arrive. Use this page to access your patient forms, prepare your health information, and see what to expect when you come to Health Builders.

Starting Care at Health Builders

Beginning care with us takes three steps. Schedule your appointment, complete your new patient forms, and meet with our care team to talk about your health and what you need help with.

01

Schedule Your Appointment With Us

Call our office or send an appointment request. Let us know what you need help with and any questions you have about starting care.

02

Complete Your New Patient Forms

Complete your forms before your visit and gather your medicines, supplements, recent test results, and records that relate to your health.

03

Meet With Our Care Team

At your appointment, we take an in-depth history and complete an examination before ordering diagnostics when needed. We explain what we recommend and what happens after your visit.

Patient Forms

Use the forms below to prepare for your appointment at Health Builders. Download and complete the forms that apply to your visit. If you are unsure which forms you need, call our office and we will help you find the correct ones.

Adult New Patient Intake

Pediatric Intake

Symptom Survey

Privacy Policy Form

Medicare Waiver

IASIS Consent Form

Auto Accident Form

For auto accident visits, this form must be filled out

Credit Card Authorization Form

Meet Our Care Team

When you come to Health Builders, you are cared for by people who take your health seriously. Our doctors, nurse practitioner, nurse, and medical assistant bring decades of experience caring for patients and families across Northern Virginia. Meet the people who will be there to listen, answer your questions, and support your care.

Dr. Hai Jin Kim, MD

Doctor of Family Medicine & Co-Founder

Dr. Brett Fuller, DC, CCSP, FIAMA, ICP

Doctor of Chiropractic & Co-Founder

Anna Sarsikov, RN

Registered Nurse

Andrea Kubota, FNP-BC

Family Nurse Practitioner

Bianca Malate, RMA

Registered Medical Assistant

Questions About Starting Care With Us?

Starting care can come with questions about appointments, forms, fees, insurance, and what to expect. We have put the practical information in one place so you can find what you need before you contact us.

Contact Us
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Schedule Your Appointment

Tell us what you need help with and how you prefer to be contacted. We will answer your questions, help you schedule with our team, and let you know what to bring.