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Helpful Forms


New patients, please complete the following forms and bring them to your first appointment.
Referral (For Physician use) Simply print and have your Physician or referring doctor fill out and fax to us


If you would like our team to coordinate care with another physician practice please complete the form below to authorize release of your medical records. For more details, please read he HIPPA Authorization information.

Medical Release Form


Appointment Request

Locations

Winston-Salem & Advance

HOURS of OPERATION

(closed for lunch 12-1)

Monday:

8:00 am-6:00 pm

Tuesday:

8:00 am-6:00 pm

Wednesday:

8:00 am-6:00 pm

Thursday:

8:00 am-6:00 pm

Friday:

8:00 am-12:00 pm

Saturday:

Closed

Sunday:

Closed