Patient Forms

Our staff can help you complete any medical forms you need.  Please review the forms thoroughly and complete your portion of the paperwork before you bring them to our office.  We suggest your drop off your forms at least three business days before you need them back.  Many forms require a recent physical exam.  if you have not received a physical exam in the past 12 months, please schedule one. 

Your medical record can be requested at the front desk.  We charge for copying records unless the record is needed to process a referral by our physician.

Please click on the links below if you would like to access these patient forms:

Patient Release of Med info - please print, complete, and take to your intial doctor's appointment

Patient Health History Form - Please print this form, complete, and take to your doctor's appointment

UNC Health Care Notice of Privacy Practices (HIPAA)

UNC Health Care Advance Directives, Living Will and Health Care Power of Attorney