Learn how At Home Harmony can help seniors age in place.

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Case Studies

Patient Case Study #1

Deborah Smith

Deborah, 72, was hospitalized for acute kidney failure and dehydration. She also has a medical history of diabetes, hypertension, depression, mild cognitive impairment, and chronic low back pain. Patient had not seen a primary care provider in more than 2 years due to transportation difficulties.

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Patient Case Study #2

Juan and Carmen Mendoza

Juan, 84, has atrial fibrillation, moderate cognitive impairment, COPD, and is unable to perform some basic ADLs alone. Carmen, 82, was the caregiver for Juan until she had a fall and broke her right hip. She has been in a post-acute rehab (discharging soon), and Juan has been temporarily cared for by daughters and neighbors. His daughters live in a different state with their own families. Juan and Carmen have not been to a primary care provider in over a year and the next available appointment is in 4 months. Transportation is a challenge.

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Patient Resources

The following forms provide information and compliance in regard to our policies, insurance, medical records and consent.

Our providers may direct you to the following forms to aid in the diagnosis and/or treatment of various clinical situations.

New to the Practice

Below are the forms you need to complete and sign electronically no later than 10 days prior to your appointment:

Our Notice of Privacy Practices

If you have been seen by an At Home Harmony Provider, we have given you our Notice of Privacy Practices to describe how your medical information may be used and disclosed. The Notice of Privacy Practices further describes your rights to your medical information.

Updates to Forms

Has your medical insurance guarantor changed? Please use the form below to provide us with updated information.

Has there been a change in who is authorized to receive health information about you? Please use the form below to provide us with updated information. If you need a copy of your current Health Information Release for Family & Friends, please call us at 804-210-3103.

Patient GUIDE Resources
Request Medical Records

To request a copy of your medical records, download the Release of Information form (see below) and fax or mail it to the appropriate location. Please be advised there may be a cost involved for this service.

Fax or mail completed form along with copy of photo ID to: 833-471-5569 or At Home Harmony, 1504 Santa Rosa Rd, Suite 114, Henrico VA 23229

 

1504 Santa Rosa Road
Suite 114
Henrico, VA 23229