Patient Forms

Assignment of Benefits, Resp, Confid
Financial Policy
Notice of Patient Information Practices
Demographics Sheet
Medical History Form
Patient Bill of Rights

Payment Information

We participate and will file insurance for you with the following plans:

Aetna Blue Cross and Blue Shield of North Carolina Cigna Health Care Humana Medcost Medicaid Medicare Primary Physician Care Tricare Standard United HealthCare WellPath

Plans other than those above are filed as a courtesy, however, payment is expected from the patient in full at the time of service. Patients without insurance are expected to pay in full at the time of service.

We accept Visa, MasterCard, Discover, personal check and cash.

Appointments

The best way to make an appointment is by calling the office. Please notify us as soon as possible if you are unable to make an appointment as we reserve the right to charge for visits cancelled with less than 24 hours notice. For administrative and filing purposes, please bring your insurance card(s) and photo id to each visit.

Legal Information

NC Bar Association
Consumer Guide to Living Wills and Healthcare Power of Attorney

Forms:
NC Living Will
NC Health Care Power of Attorney

* We are not attorneys and do not represent ourselves as providing legal services. For more information you may contact an attorney or the North Carolina Medical Society.