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Forms
To make things as easy as possible for our patients we have posted our patient information forms in
PDF format. If you don’t have a PDF viewer you can download Adobe Reader
here.
You can then print out the forms and fill them out at your leisure and bring them with you to your exam.
You can also fill them out electronically and submit the completed forms to us. We strive to protect your
privacy and all medical information submitted will be stored on our secure server.
These forms will help you save time and ensure that our records are correct. We have our new and
returning patients fill out theses forms at each visit so that our records are as up to date as possible and
allowing us to provide the best care possible.
Downloadable forms:
Patient Information form - pdf file
Financial Policy-pdf file
HIPPA privacy policy-pdf file
Record Release - pdf file
Electronic forms:
Patient Information - Electronic submission
Dr. Roger Davis
Dr. Lisa Davis
Dr. Larry Schonhofen
Dr. Kelly Reid
Dr. Angela Sellers
Dr. Jeanne Chen
Greensboro
Winston-Salem