| 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.
|
|