We are happy to provide our office forms for convenient download on your home computer.
Please print and complete the forms below, and bring them with you to your child’s appointment.
NEW PATIENTS
- New Patient Forms (English)
- New Patient Forms (Español)
- HIPAA Notice of Privacy (English/Español)
- The privacy notice is for your information only. You do not need to bring this to your appointment.
- NCHealthConnex Opt-Out Form (English/Español)
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SCHOOL FORMS
- Kindergarten Health Assessment Form
To be completed by parent - Sports Physical Form
To be completed by parent - Flu Vaccine Form
For flu vaccine only visits, to be completed by parent