Patient Forms

Download Patient Forms

Before your appointment with us, quickly and conveniently access patient forms from our practice.
To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.

• New Patient Packet
• WIC form birth to 12 months
• WIC form 12 months and older
• NC Sports Physical Form
• NC Children’s Medical Report
• NC School Medication Form
• NC Kindergarten Health Assessment Report 2011
• ADHD Initial Evaluation Questionnaires
• Flu Questionnaire

Insurance & Billing

It’s important to ensure that your healthcare provider is in-network with your insurance company before seeking medical care. This can prevent unexpected out-of-pocket expenses and ensure that insurance benefits are utilized to the fullest extent. Additionally, your insurance plan requires you to have a Primary Care Provider (PCP), it’s essential to confirm that the healthcare provider is listed as the PCP to avoid any confusion or billing issues. Patients should always check with their insurance company and confirm that your healthcare provider is in-network and listed as the PCP if necessary.

Insurance We Accept:

Download Office Policies

• Notice of Privacy Policy
• Financial Policy
• Patient Information Guide