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  • Clinic Hours:
    Mon - Thurs: 8:00 am - 5:00pm
    Friday: 8:00 am - 12:30 pm
    336-940-2407
  • Med Spa Hours:
    Monday - Friday: 8:00 am - 5:00pm
    336-940-3875

Patient Forms

The packets below have all the combined forms a new or existing patient needs for an upcoming visit. Printing these from home and bringing them in will allow for faster check in!

Individual forms are also listed here for your convenience.

Medical Questionnaire Form

Authorization to Disclose Protected Health Info

Authorization to Disclose Protected Health Info – Patients Request

Financial Policy

Notice of Privacy Practices

 

*The packets and forms above require the free Adobe Acrobat Reader, if you do not have Acrobat or need the latest version, click here.