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.
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.