New Patient Forms
Notice of Privacy Practices
Patient Acknowledgment of Notice of Privacy Practices
Designated Party Release Form
Access Request Form
Accounting Request Form
Alternate Means of Communication Request Form
Amendment Request Form
Revocation of Authorization Form
Use or Disclosure Authorization Form
Request Authorization Form
High Rock Internal Medicine PA104 West Medical Park DriveLexington, NC 27292Phone: 336-224-0931Fax: 336-224-0932
104 West Medical Park Drive Lexington, NC 27292