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Listed below are forms that you can print, fill out at home, and bring with you to the office on your visit. They are in PDF format, so you will need Adobe Reader to view them. If you do not currently have Adobe Reader installed on your computer, click here to download the free program.

  Authorization for Release of Information
  Health History
  New Patient Information
  Notice of Privacy Practices
  Request for Release of Patient Records

 

 

 



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198 Hospital St     Mocksville, NC 27028     336.751.2364
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