Lori Birdsong M.D.

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New Patient Forms - Archive

If you are visiting our office for the first time (or have not seen Dr. Birdsong for 2 or more years), please bring these completed forms with you so that there will be no delay with your appointment:
  • Patient Information Sheet
  • New Client Face Sheet
  • Patient Signature Form
  • Cancellation Policy Acknowledgement

Once you had your initial appointment in office with Dr. Birdsong, she may offer you a follow-up appointment via Tele-Health (i.e. online video chat). In that case, you will need to visit the Tele-Health page and fill out these additional forms:
  • Consent to Tele-Heath form (only before your first Tele-Health follow-up appointment).
  • Tele-Health Appointment form (appointment specific - must be filled out prior to each appointment).

We accept BCBS (except for Blue Value and Blue Medicare), United Healthcare, Aetna, and some Medicare plans.
​Call (910) 763-3034 to confirm your insurance and make an appointment. 
Handicapped accessible.

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