patient relations contact form

Contact our team

Have a question or need assistance? Our Patient Relations team is here to help you with any inquiries or concerns. Please fill out the form below, and we’ll get back to you as soon as possible.

Would you like to contact Inova-GoHealth Urgent Care? Please use the button below.

Inova-GoHealth Urgent Care

Do you need help with billing or medical records? Please refer to the following pages for assistance. Please do not contact patient relations for these types of inquiries:

Billing Medical records

Primary contact name

Please provide your first and last name, or the name of another designated primary contact

Primary contact phone number

Please provide the best phone number to reach you or the designated primary contact

Primary contact email address

Please provide the preferred email address for you or the designated primary contact

Patient's first and last name

Please provide the patient's first and last name (as this may differ from the primary contact)

Is the patient currently admitted to an Inova hospital?

Yes

Which Inova service area are you reaching out to Patient Relations about?

Have you been in contact with a member of the Patient Relations team regarding this concern or compliment, either by email or phone?

Yes, I am in contact with someone from the team

No, I am not in contact with anyone from the team

Unsure or do not recall the name of the team member

Please enter the person's name

Please use the space below to provide a brief overview of the concern or compliment that you would like to discuss with the Patient Relations team. Please refrain from sharing personal information such as birthday, personal health information or medical record numbers.

*Please note: For privacy and security reasons, this field is limited to 250 characters. Please provide only a very brief summary of what you’d like to discuss with Patient Relations. When Patient Relations connects with you, they will discuss the details with you directly.

CONFIDENTIALITY NOTICE: Communications via email over the internet may not be secure. Although it is unlikely, there is a possibility that information you include in an email can be intercepted and read by other parties besides the person to whom it is addressed. Once received, lnova shall take every precaution to maintain adequate physical, procedural and technical security with respect to our offices and the information storage facilities so as to prevent any loss, misuse, unauthorized access, disclosure or modification of the user's personal information under our control. For additional information about data privacy, please read Inova's web privacy statement.

Patient Relations Contact Form

Contact our team