Click Here to log in to Patient Portal

Patient Forms


 

Here you can find the most common forms that we require before your appointment. For your convenience, you can download the forms, complete them and then bring them with you when you come for your appointment.  If you are an established patient but have not been seen in over a year, you can save time at check-in by updating these forms and bringing them with you.

 

Patient Portal Access   

We have a Patient Portal through NextMD that provides an easy way to update your information.  You must receive a "token" number from our office and then register on the portal with a user name and log in.  The process is very simple.  If you are interested in having a portal account, please call our office today and request a "token" number. Anyone who answers should be able to provide this to you. Once you have an active portal account, we can upload your records and lab results with a click of the mouse!  

Click the NextMd logo to sign in:


If you already have a token number but haven't registered, please go to www.NextMD.com to register. Token numbers last for 30 days.  If you haven't registered within 30 days, call the office so we can assign you a new token number.

Download Patient Forms 

Please print the Patient Registration Forms, fill out all pages and bring with you to speed up your registration process.

New Patient Forms 

Established Patient Update Forms

PHI Release

Notice of Privacy Practices Trifold

Patient Satisfaction Survey




Central Carolina Foot & Ankle Associates

NORTH DURHAM
INDEPENDENCE MEDICAL PARK
4119 Capitol Street
Durham, NC 27704 
(near Duke Regional Hospital) 
919-477-9333   

SOUTHWEST DURHAM
HIGHGATE CENTRE
5107 Southpark Drive
Suite 202
Durham, NC 27713 
(close to RTP and Chapel Hill)
919-544-2583 

RALEIGH
ALEXANDER OFFICE PARK AT BRIER CREEK
7920 ACC Boulevard
Suite 100-A
Raleigh, NC 27617
919-533-4200