Fill out the New Patient Registration form online
Download the New Patient Registration Form to print
These forms are to be completed prior to your first appointment at our office. Please remember to bring them with you, along with your insurance card. You might also want to print off a Transfer of Records form to obtain any old records from your previous doctor before your visit. It is also a good idea to complete the relevant Health History Form so the doctor has record of your past problems and conditions.
Transfer of Records
This form will request your former physician or health practice to transfer records to Family Care, PA for continuing care, or consultation.
Health History Form
This form is to Update your health history and symptoms you have had in the past year. Please complete this form prior to your annual physical examination. Bring this form with you to your next visit.
Sports Physical Form
This form is the approved form for participation in athletics by the State of North Carolina Department of Public Education. Complete the parents portion and bring it to your next visit.
Brochure for Pre-Paid Plan
This is a plan we offer to patients without insurance or with an out of network insurance to help plan their medical expenses for the year and receive a discounted rate by signing up for a package deal.