Forms

Welcome to Early Bird! Happy to have you!

 

Please fill this NEW PATIENT REFERRAL PACKET AND CONSENTS and someone will contact you in 48 business hours to see how we can help you and your family! If you are new to us and have not yet give us your information, please CLICK HERE.

 If our online referral form gives you trouble, please call 704-846-0262 to make a referral 

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If you are an established patient and you have been referred here to sign your OPENING PAPERWORK, CLICK HERE.

 

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If you are an Physicians office, case manager, social worker, or an advanced medical provider wanting to make a referral for your patient/client, please CLICK HERE. Be sure to fill out as many of the blanks as you can

 

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Additional Documents for Existing Patients

Release of Healthcare information form CLICK HERE.

Backpack Notebook Consent Form

Preferred Provider Letter CLICK HERE.