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College Student Patient Registration

We are required by law to inform you about your privacy rights and ask that you sign our Business Policy and Patient Agreement indicating that you have had this opportunity. You may click on Privacy Policy (HIPAA) and download a copy or ask for a copy at our office.

Please take this time to read the information carefully, complete the forms and bring them with you to your first appointment.

• College Student:
  1. Patient Information Sheet for College Students
  2. Business Policy and Patient Agreement
  3. Financial Responsibility Form

Raleigh office: 1004 Dresser Ct, Suite 103, Raleigh, NC 27609 | 919-876-5658

Cary office: 1340 SE Maynard Rd, Suite 201, Cary, NC 27511 | 919-481-9012