Patient Registration Forms


 

Please click on each icon, downloading should start instantly if you have any problems please contact us at (704-910-8380)

Notice of Privacy Practices (English)

Notice of Privacy Practices (Spanish)

New Patient Paperwork (English)

New Patient Papwerwork (Spanish)

Blue Crosss Blue Shield 

Patient Fusion (English)

Please click the link above, this will send you to a new window.

We will send you a email with all of the details with a username and a temporary password

Patient Fusion (Spanish)

Por favor, haga clic en el enlace de arriba, este le enviará a una nueva ventana.

Le enviaremos un correo electrónico con todos los detalles con un nombre de usuario y una contraseña temporal

Location
South Charlotte General and Vascular Surgery
10512 Park Road, Suite 111 & Suite 210
Charlotte, NC 28210
Phone: 980-216-8186
Fax: 704-817-9980
Office Hours

Get in touch

980-216-8186

South Charlotte General and Vascular Surgery
10512 Park Road
Suite 111 & Suite 210
Charlotte, NC 28210