If you are a new patient, your insurance, or personal information has changed please print and fill out this Patient Registration Form and present it when you check in on the day of your appointment.
If you would like to have records transferred to CFPSM from another practice or from our practice to another location, please print and fill out this Records Release Form and follow the instuctions appropriate for your needs.
If you would like to allow CFPSM to share your protected health information with your spouse, significant other, parents, friends or any other person other than yourself please fill out this
Permission to Communicate with Friends and Family Form. We will not share your information without a copy of
form on record.
| If you are bringing your child for his or her annual well child check-up please print out one of the following Ages and Stages Questionnaires that correspond with your child's age. The questions and exercises in these forms will give you and your doctor a good idea about your child's development: |
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We value your opinion of our service, and hope you will take a moment to fill out our Patient Satisfaction Survey.
Mail to CFPSM, 8300 Health Park - Suite 107, Raleigh NC 27615 or email to awest@cfpsm.com