5900 Six Forks Road, Suite 200
Raleigh, NC 27609
Phone: 919-876-4327
Office Hours:
Monday - Friday
8:30am to 5:00pm

Patient Resources

Patient Resources: Helping Our Patients Outside of the Office

Patient Forms

New Patients:
Please print out, complete, and bring to your scheduled appointment.


Directions to Carolina Ear and Hearing Clinic   Download - Directions to Carolina Ear and Hearing Clinic

Patient Registration Form   Download - Patient Registration Form

Medical Questionnaire   Download - Medical Questionnaire

Financial Policy   Download - Financial Policy

Notice of Privacy Practices   Download - Notice of Privacy Practices

Acknowledgement of Receipt of Notice of Privacy Practices   Download - Acknowledgement of Receipt of Notice of Privacy Practices

If you would like a copy of your medical records,
you must fill out and return the following form at your earliest convenience.

Financial Policy   Download - Health Information Release Form