- Initial History and Nutrition Assessment covering your health history and current medial issues so Dr. Hughes will be prepared for your visit.
- New Patient Information Form with information about appointment scheduling, prices, and payment policies so you will understand her office policies.
Microsoft Word version: Initial History and Nutrition Assessment
- Download the form to your computer and fill it out.
- Save the file and print a copy.
- Email the completed form to email@example.com, or
send the printed copy via FAX: 919-783-8299, or US Mail: 4208 Galax Drive, Raleigh, NC 27612-3714
If you e-mail the form, you’ll be asked to sign it at the first appointment.
- Please print and sign the New Patient Information Form. If you e-mail your history, you may bring the signed form to your first appointment.
Printable version: Initial History and Nutrition Assessment (includes New Patient Information Form)
- Print the form and type or print clearly.
- Sign the included New Patient Information Form.
- Return by FAX: 919-783-8299 or US Mail: 4208 Galax Drive, Raleigh, NC 27612-3714