You can download copies of these forms to use at your convenience. You will need Acrobat Reader to view the file. Acrobat Reader is free and can be obtained from the Adobe site.

New Patient Forms

(see below for New Child Patient Forms)

New Adult Patient Registration

HIPAA Notice (Privacy Policy)

HIPAA Acknowledgement

Adult Medical Records Disclosure and Medical Records Release


Patient Forms

Headache Diary

Sleep Diary

Sleep Study Information

Sleep Study Questionnaire

Comment or Complaint

Narcotic Contract


Child Neurology Forms

New Child Patient Registration

HIPAA Acknowledgement

Child Medical Records Disclosure and Medical Records Release

Guardian Release Form

Child Patient Profile

Child Headache Calendar

Sleep Diary


Map to Our Office

Map to RNA

 

   
Dr. John D. Wooten
A Garner native, Dr. Wooten graduated from Duke University in 1980 More
Dr. Kevin M. Rathke
A clinical researcher focused on epilepsy and headache … More
Dr. Traci I. Sheaffer
Dr. Sheaffer was born in Asheville, NC and graduated… More
Dr. Kristi L. Milowic
Dr. Milowic was born in Hawaii and as a child of a military family… More
Wanda Cecil
Certified pediatric nurse practitioner Wanda Cecil completed her … More
Child Neurology Services & Procedures

Evaluation and treatment of child neurological and developmental disorders

This area is under construction.