patient forms

Charlotte Area Offices

Downloadable Patient Forms
Please click the links below to download, print, and complete patient forms prior to coming to our office.

Patient Information Form (Type directly on form and print out if you have Adobe Reader)

Medical History (Type directly on form and print out if you have Adobe Reader)

Privacy, Financial, and Medication Policies


Patient Privacy Forms (HIPAA)
Notice Of Privacy Practices - English Version

Anuncio De Como Manejar La Privacidad - Spanish Version

Authorization To Release Protected Health Information (Medical Records)
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