UPDATED: COVID-19 Vaccine Information and Resources. Learn more. Proudly part of Privia Health Cardiac Care Associates Menu MAKE AN APPOINTMENT Patient Forms Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment. Patient Forms Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology. Office Policies Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF) HIPAA Privacy Notice HOSPITAL AFFILIATIONS Inova Fair Oaks Hospital Inova Fairfax Hospital Loudoun Hospital Center Reston Hospital Center Cardiac Care Associates 1830 Town Center Drive Suite 405 Reston, VA 20190 703.481.9191 571.423.5082 OTHER LOCATIONS Meet the Team Carla Reynoso, FNP Michael Banihashemi, MD, FACC, RPVI Kenneth M. Brooks, MD, FACC Douglas (Alec) Hill, MD, FACC Bhanu Krishnan, MD, FACC See More Patient Resources About Us When you are a Cardiac Care Associates patient, you will establish a one-to-one relationship with one of our outstanding cardiologists. You will know your doctor and your doctor will know you. Our nursing, front office and back office staffs are committed to making sure you get the care you deserve. ©2021 Privia Health, LLC | All Rights Reserved | Privacy Policy | Terms of Use | Language Services | HIPAA Privacy Notice About Privia Careers Press Room Prospective Doctors