April 19, 2018        Login      
Office Hours

Monday

8 a.m. - 5 p.m. 

Tuesday

8 a.m. - 5 p.m.

Wednesday

8 a.m. - 5 p.m.

Thursday

8 a.m. - 5 p.m.
Friday  8 a.m. - 5 p.m. 
   

Phone

      828-304-6363

 
 
You are visitor number: 100614
 Patient Forms   
 
Forms

New patients have the option to download and print the forms to complete manually to bring with them to their first appointment or forms can be completed and sent to our office securely online.

Established patients also have the option to make changes to their information using either of the form choices below.         
 
 

     
       

Triple Authorization Form 

Download & Print   Secure Online Form

Release of Information Authorization

Download & Print
  Secure Online Form

Patient Information

Download & Print
  Secure Online Form                       

Formulary Benefits Consent Form

Download & Print   Secure Online Form

Medical Record Release

Download & Print 

  Secure Online Form

Patient Privacy Notice

Download & Print  
Download & Save/Print

Previous Medical History

Download & Print   Secure Online Form
Family & Friends Consent Form Download & Print   Secure Online Form
 
 Call today to set up an appointment  828.304.6363

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