NEW PATIENTS

For NEW PATIENTS

Our office sees new patients by referral only. We request you get a referral from your primary care physician.   Your pediatrician or primary care physician will need to complete the Referral Form and parents should fill out the Initial History Form . Both should be faxed or sent to our office. Please allow us a 2 weeks to process your paperwork. After processing we will send you a link to a rating scale via e-mail.  Please complete the on-line rating scale, which should take 20-30 minutes to complete.  When you finish the scale it will come back to us to be scored.  Your child's name will then go on our wait list for an appointment.  Please be advised that at the present time, we have approximately a 2 month wait for new appointments. Your patience is greatly appreciated.


Physicians within the UNC physicians network, please use the forms on the UNC-PN tab.  

Forms for NEW patients

Referral Form (completed by referring provider)


Initial History Form (completed by parents)


Consent & Financial Policy  (for review - you will sign in the office)


UNC Physicians Network  Packet (completed by UNC provider ONLY)