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get in touch

Registration Forms

PDF Fill-in Forms

Firefox (Go to options/application/portable document format and choose use Adobe to use fill-in)

HIPPA and Privacy Practices Form

HIPPA Signature Form

Demographic Form

Past Medical Hisotry

Release of Records

Contact List:

Contact via e-mail:

Please use your patient portal for medically related questions including referrals, medication refills, current medical symptoms or follow-up medical care questions.

For General Questions Click Here

For Billing Questions Click Here

 

Telephone:

For after hours call please call 919-859-2566. Follow the instructions and enter your call back number with the area code. All after hours call are limited to true emergencies. Provider on-call can not call in prescriptions after regular business hours. There will be a $25 charge for non-emergency calls.

Telephone 919-859-2566

Fax 919-859-5252

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