425 North Wendover Road Charlotte, NC 28211-1064
Select Page

Office Policies & Forms

Important information for our valued patients.


We make every effort to be on time for our patients, and we ask that patients please arrive on time for their scheduled appointments. If an appointment cannot be kept, we require a 24-hour notice to change or cancel the appointment. Unless there is an emergency, failure to give notice may result in a cancellation fee.



Professional care is provided to you, our patient, and not to an insurance company. Thus, the ultimate responsibility for payment lies with the patient. We will gladly file your treatment claims with your insurance company. The estimated portion of your charges (not covered by insurance) will be due at the time of service.

We accept cash, check, MasterCard, Visa, American Express, and Discover Cards as payment.

Care Credit is our payment plan option. This option offers low monthly payments, including interest free plans. Apply online or through our office.

Document Includes:

– New Patient Information Sheet
– Medical History
– Cancellation Policy
– Patient Owed Balances
– Friends and Family
– Acknowledgement Of Privacy Practices
– Notice Of Privacy Practices