Forms and Insurance

Patient Privacy and Forms

If your appointment is a Medicare Annual Wellness Visit:

If your appointment is an Annual Physical:

If you are a New Patient:

Patient Privacy

FMAR Notice of Privacy Practices

Release of PHI Authorization

Release of PHI Authorization Form

Patient Registration

Patient Registration Form

Medical Records

Medical Records Form

Patient Acknowledgment and Consent

Patient Acknowledgment and Consent Form

Patient Responsibilities

Patient Responsibilities Form

Financial Responsibility

Patient Financial Responsibility Policy

DEXA Questionnaire

DEXA Questionnaire

DOT Medical Examiner Form

DOT Medical Examiner Form

Please Note: We are unable to accept referral patients from Dr. Lapps office. Dr. Lapps has retired.

June is Migraine Awareness Month!

For more information on migraine management visit the National Headache Foundation's website On the website you can find great information on how to have fewer, shorter and more tolerable headaches. You can also donate to their cause and learn about their upcoming events. 

Don't forget to attend our FREE educational discussion on migraine management on Wednesday, June 20th from 6:30pm to 7:30pm. The discussion will be led by a Neurologist by the name of Mitch Freedman, MD. It will be held in the lobby of our family medical practice located at 3500 Bush Street in Raleigh. We hope to see you there!

August is National Immunization Awareness Month!

Shots can prevent infectious diseases like measles, diphtheria, and rubella. But people in the U.S. still die from these and other vaccine-preventable diseases. It's important to know which shots you need and when to get them. 

Are you unsure about what immunizations you or your children should be up to date on? Check out the Centers for Disease Control and Prevention website for age specific information about vaccines and immunizations.

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