Alert

Patient Forms & Information

Download Forms

Save time at your appointment by filling out these forms ahead of time. Use this link to print the forms, then fill them out and bring them with you to your appointment.

Patient Forms to Complete Before Appointment - ALL PATIENTS

Patient Pre-Registration Forms

Patient Pre-Registration Forms - Spanish

General Consent for Treatment Form - Spanish

Specialty Forms

Please fill out the forms below if you are scheduled for one of these procedures. If you have any questions, please contact our office at 919-784-7874.

Bariatric Surgery Forms - English

Bariatric Surgery Forms - Spanish

Breast Patient Pre-Registration Forms - English

Breast Patient Pre-Registration Forms - Spanish

Endocrine Questionnaire

Medical Weight Loss Forms – English

Medical Weight Loss Forms – Spanish

Psychiatry Consent for Treatment - English

Psychiatry Consent for Treatment - Spanish

Patient Rights Forms

Patient Rights - English

Patient Rights - Spanish

Billing & Insurance

Health insurance is filed as a courtesy by our staff. We ask that patients please provide current and accurate information regarding insurance coverage. We are participating providers for Medicare, Medicaid and various HMOs and PPOs. All co-payments are expected at the time of service. Any outstanding balance that remains after payment from the insurance company is due within 30 days. We accept cash and checks. View our list of accepted insurance plans.

Related Locations

Top