Samantha Toerge, M.D.LLC

Patient Forms

Please print and fill out these forms so we can expedite your first visit:

  • Patient Information Sheet (PDF)
  • Patient History and Intake Form (PDF)
  • Patient HIPAA Form (PDF)
  • Under 18 Consent Form (PDF)

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

Our Location

5454 Wisconsin Ave, Ste 1400, Chevy Chase, MD, 2081

Office Hours

Office is closed for lunch hour between 12:00 PM and 1:00 PM

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 am

Friday:

8:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Coming Soon.