New Patient Forms

New Patient Packet (FULL)

If you have scheduled a New Patient Appointment, kindly please complete a New Patient Packet. This form is required prior to your initial appointment.


If you have NOT scheduled a new patient appointment you may also complete this form. The receipt of this form will alert a member of our staff to call you.

This form is fully online, there is no need to print it out, scan or email. Once you complete it, the form comes directly to our staff.

Before you complete this form:

* Please allow 15-20 minutes to complete.
* Complete the from on a computer.
* Have your insurance card handy.
* Have a list of your medications available.

7780 Brier Creek Parkway

Suite 306

Raleigh, NC 27617

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Phone: 919-582-7272

Fax: 919-582-7274 OR 877-745-2672

Psychiatrist in Raleigh - Medication Management - Psychiatric Evaluations - Accepting New Patients

The content on this website is for general information and educational purposes only, and is not intended to substitute professional services.