Acceptance into our practice

All patients seeking entry into the practice are pre-screened based on information reviewed through available North Carolina databases and review of the completed health history information below. Patients must complete this information at least once with annual updates. Incomplete or unsigned applications will not be processed for acceptance.

Reasons for entry denial may or may not be disclosed to you. Reasons for denial can include high-level medical complexity, multiple prescribing providers, failure to report the use of controlled prescription medications, history of narcotic or controlled medication use, recommendation of Ashe Family Healthcare provider or employee, history of medical non-compliance, or a history of illegal activities.

It is our policy to report to local law enforcement any suspicion of illegal activities including patient abuse and trafficking of prescribed medications.

^top  Contact  Link

New Patient Forms

You can download our new patient form at the link below.

► Download:
⇑ Click to close
AFH-New Patient Packet 9 2015 ( pdf 3.6 Mb)
AFHC new patient form ( pdf 307.6 Kb)

^top  Contact  Link