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Health Questionnaires

Having an accurate and complete health history can make all the difference in a patient's treatment plan.

To download a copy of our health questionnaires, please click on one of the links below.

Adult Questionnaire

 If you are over the age of 18 please print out this form, fill it out and bring it in with you on your first visit.

Click here to view and print this document

 

Youth Questionnaire

If you or your child is under the age of 18 please print out this form, fill it out and bring it in with you on your first visit.

Click here to view and print this document

Contact Us

1404 Beatties Ford Rd
Suite 200
Charlotte, NC 28216
Directions

 

Telephone: (704) 375-7005

Fax: (704) 375-7030

Please call to schedule an appointment.

 

Monday       8:30AM - 5:00PM
Tuesdays    8:30AM - 5:00PM
Wednesday 7:30AM - 4:00PM
Thursday     8:30AM - 5:00PM


Visits are by appointment only.