Existing Patients

Thank you for being a part of the Winchester Pediatric Clinic family. Please find the information below for accessing your Patient Portal for health records, administrative forms, and more.

Patient Portal

Winchester Peds provides its parents with a secure online patient portal system that is convenient for managing health information, requesting refills, updating demographic information, and more.

Urgent After Hours Clinics

We offer “Emergency Only” walk-in clinics. These clinics are for urgent problems only. For anything that
can wait for the next day, you may make an appointment during our regular hours. Otherwise, anyone
who registers during the times below will be seen. Hours are subject to change and will be posted on the
door of the practice.

Monday – Friday: 6:30pm to 7:30pm
Saturday, Sunday & Holidays: 9:30am to 10:30am and 4:30pm-5:30pm

Forms

A list of PDF forms will soon be available for download.

Referral Policy

Call for referrals 540-667-1727

HIPAA

CLICK HERE to review our Notice of Privacy Practices (HIPAA policies).

Fees

Co-Pays/Co-Insurance Billing Fee: $10
Co-pays are always due at the time of service. I agree to pay a $10.00 billing fee for each payment,
including co-payments and co-insurance, not made at the time of the visit.

Missed Appointment/ No-Shows: $25
I agree to pay a $25.00 fee for missed appointments that are not canceled at least 24 hours in advance.
Please note the date and time of your appointment when made. APPOINTMENT REMINDERS ARE A COURTESY,
and you may not always receive one.

Returned Check Fee: $50
I agree that if a check is returned to my account for any reason, I will be responsible for a $50.00 returned
check fee in addition to the original fees for services.

Monthly Service Fee: 1 1/2 % per month
All accounts over 30 days may be charged a service fee of one and one-half percent per month, eighteen
percent per annum.

Form Fees: $5-$30

  • $5 for forms such as School Entrance Forms, etc.
  • $15 for long forms such as FMLA, Handicap Parking, etc.
  • $30 Form Rush Fee (completed in one business day), Add-on fee.

After Hours Call Fees: $20

Prescription Refill Fee: $15
Any refills needed before or after your appointment will be subject to a $15 fee.

Medical Records Patient Fees: Vary
Virginia law permits a charge for personal copies or transfers of your medical records. Either CIOX Health, a Datavant Company, a contracted third-party vendor, or WPC will provide this service, and you will be invoiced directly by the respective provider. Virginia rates are $0.09 per page, plus actual postage, supply costs, and labor costs. The electronic delivery portion is a flat rate of $6.50, plus applicable sales tax. Prices differ for other entities.

Medical Records Fees for Attorneys, Insurers, and Others Authorized by Patients:
Paper Copies
$0.50 per page up to 50 pages
$0.25 each additional page
$20.00 Search & Handling Fee
Plus shipping costs

Electronic Format
$0.37 per page up to 50 pages
$0.18 each additional page
$20.00 Search and Handling Fee
Plus shipping costs
$150.0 Maximum Total

The above fees are not reimbursable by your health plan coverage. All fees, including fees for medical services and supplies, are
subject to change without notice.