2053 Valleygate Drive
Suite 101
Fayetteville, NC 28304
 
(910) 323-9222 phone
(910) 221-9220 fax
Please call for an appointment today.
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We at Cape Fear Otolaryngology
would like to express our deepest gratitude to
our patients, colleagues, and friends
for your continued support as
we enter another year in practice.
 
  Cape Fear Otolaryngology
  Downloadable Forms
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In order to serve you better, we ask that you present these forms during the check-in process.
Please have the following available:
  • An updated Insurance card and referral
  • Driver's license
  • Social security number
It is especially helpful to our providers if you are able to bring your medical records, a list of your current medications, and any recent diagnostic test results.  We look forward to serving you.

Disclosure & Privacy Notification

Financial Agreement

Medical Records Release

New Patient Questionnaire

Referral Form
 

 
 
 
 
 
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