Patient Forms

Below we have forms for both new and current patients attending our facility. If you are attempting to establish your child/children/self with us, updating account information, or needing specific paperwork for a future visit, you most likely will find the necessary form(s) below.
2016 Pop Warner Sports Physical form for all player participating in Pop Warner sports this coming fall/spring

Due to recent changes in NC Medicaid, unfortunately, many policy holders have fallen victim to a glitch in the system which has been reassigning patients to a different office. If you have been told, or notice on your child's medicaid card that it does not have our name, please fill out this form and submit to us, and we'll deal with the issue to the best of our ability.

Are you a new patient interested in becoming a part of our practice? Just fill out this form and submit at your earliest convenience.

Form required for any child changing schools, entering either Pre-K or Kindergarten, or updating of information at school.

Is Your Child Sick?TM

Office Hours

Monday & Wednesday  9:00am - 5:00pm
Tuesday & Thursday  9:00am - 6:00pm
Friday 9:00am - 1:00pm
Saturday & Sunday

239 Wilmot Drive,
Gastonia, NC 28054