• New/Returning Required Patient Information ( prints four pages )

• HIPAA Privacy Policy ( optional )

• Pre-Op Instructions ( optional )

• Post-Op Instructions ( optional )

 

• Medical Records Transfer Request ( optional )

• Referral Slip for Charlotte Offices ( providers only )

• Referral Slip for Albemarle Office ( providers only )

 

For your first visit with our practice or if you are a returning patient who has not been seen by any of our doctors in a year or more, you will need to print four required forms by clicking on the link at the top.

We ask that you please read our HIPAA Privacy Policy. Print for your records only.

You will be given verbal and written aftercare instructions at the time of your procedure.

It is not necessary to print the post op care instructions before the date of your surgery.

If you are unable to see/print these forms you will need to update your Adobe Reader.

If you are a Mac user you may need to view this website in Firefox to print forms in the correct format.

Click here to download the latest version of Adobe Reader from the Official Adobe Website.

Click here to download the most recent version of Mozilla Firefox from the Official Mozilla Website..

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