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Forms For Your Visit

 

As you would expect, new patients are asked to complete several forms at their first office visit.  

 

The Patient Registration Form requests various personal and insurance information.  Click the button to the left for a copy of the Patient Registration Form.  This document contains fields that can be filled in on your computer and printed.  

 

In addition, all new patients must complete the Medical History Form.   The information requested is very detailed.  We suggest that you fill out this form prior to the office visit.  Click the button to the left for a copy of the Medical History Form.  This document also contains fields that can be filled in on your computer and then printed.

 

You should plan on arriving no later than 30 minutes prior to your first scheduled office visit.  Please bring your current insurance card and any medications (including supplements) your are taking.

Location

 

4205 Capital Drive

Rocky Mount, NC 27804

 

 

CONTACT US

 

Email (Preferred): lipidmd@gmail.com

 

Phone: 919-569-5971

 

Fax: 919-429-8143

Text: 919-583-7981

 

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