Forms

If you are NEW TO EARLY BIRD or RETURNING AFTER A BREAK IN SERVICE, 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!  CLICK HERE.

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

Si es NUEVO EN LA RESERVA ANTICIPADA o REGRESA DESPUÉS DE UNA INTERRUPCIÓN EN EL SERVICIO, complete este PAQUETE DE REFERENCIA DE PACIENTE NUEVO Y CONSENTIMIENTOS y alguien se comunicará con usted en 48 horas hábiles para ver cómo podemos ayudarlo a usted y a su familia,  CLIC AQUÍ.

Si nuestro formulario de referencia en línea le causa problemas, texto 704-995-2900.

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

Si usted es un paciente establecido y ha sido referido aquí para firmar su DOCUMENTO DE APERTURA,  CLIC AQUÍ.

 

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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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Current Early Bird families – if your insurance has changed, please CLICK HERE to update us! Thanks! 

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Additional Documents for Existing Patients

Release of Healthcare information form CLICK HERE. Formulario de divulgación de información médica HAGA CLIC AQUÍ.

Preferred Provider Letter CLICK HERE.  Carta de proveedor preferido HAGA CLIC AQUÍ.

Backpack Notebook Consent Form CLICK HERE.

Consentimiento del cuaderno para la mochila CLICK HERE.