Show Navigation
Primary Care South End
Go
Home / Patient Tools / New Patient Information & Forms

New patient information & forms

We are pleased that you have chosen Novant Health Primary Care South End. Please arrive at least 15 minutes ahead of your appointment.

Please bring the following items to your appointment:

  • Insurance card
  • Insurance copayment and payments toward your deductible. If we do not have medical insurance, please be prepared to pay for services rendered at the time of your visit.
  • List of current prescriptions and/or over-the-counter medications you are taking, along with information about dosage and frequency of use.
  • Records of your medical and surgical history.
  • Logs that provide details about your insulin and sugar levels, if applicable.

You can complete the following forms ahead of time by clicking on the links below. If you do not complete these forms ahead of time, they will be available in our office:

  • Patient Information/Consent To Treat
  • Authorization To Disclose Health Or Billing Information
  • Communicating Your Health Information
  • Adult History Questionnaire
  • Pediatric History Questionnaire
  • Personal Data Sheet
  • Pediatric Personal Data Sheet
  • Location

    Hours

    Monday to Friday
    8 a.m. to 5 p.m.