- Patient Information Form
- Medical History Form
- Credit Card Authorization Form
- Insurance Coverage Waiver Form
- Parental Acknowledgement to Treat Minor Children When Not Accompanied by Parent or Legal Guardian
- Written Acknowledgement of Receipt of HIPAA Notice of Privacy Practices
- HIPAA Authorization to Use and Disclose Protected Health Information
- HIPAA Release and Authorization Form for Patients Over 18
- Request for BPAD to Release Medical Records
- Request for Medical Records to be Sent to BPAD
- Prescription Refills and Prescription Prior Authorizations
- Financial Policies
- Patient and Family Responsibilities
- Patient and Family Bill of Rights
- After Hours Access to Care
- Divorce, Separation, Foster Care and Custody Agreements
- HIPAA Notice of Privacy Practices
- HIPAA Notice of Privacy Practices for Patients Over 18
Turtle Coloring Pages
Let kids be kids;
just let them be
let the bath be the sea!
Let them stare at the sky
and find animals in the clouds.
Let them dance in the rain
and sing out loud.
Call us at (919) 476-1118 or request an appointment below.
We’re looking forward to seeing you!
REQUEST AN APPOINTMENT
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