New Patient Forms
Due to the Corona virus/COVID-19 pandemic, Dr. Birdsong will be seeing ALL new patients via Tele-Health (please do not come to the office).
If you are a new patient (or have not seen Dr. Birdsong for 2 or more years), please complete these 7 forms and submit them prior to your Tele-Health appointment (please do not come to the office).
Instructions for how to submit your form.
If you are a new patient (or have not seen Dr. Birdsong for 2 or more years), please complete these 7 forms and submit them prior to your Tele-Health appointment (please do not come to the office).
- Patient Information Sheet
- New Client Face Sheet
- Patient Signature Form
- Cancellation Policy Acknowledgement
- Authorization to Exchange Health Information (with another provider, if necessary)
- Consent to Tele-Heath form
- Tele-Health Appointment form (appointment specific - must be filled out prior to each appointment).
- Picture of the front and back of your driver's license
- Picture of the front and back of your insurance card
Instructions for how to submit your form.
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.
Call (910) 763-3034 to confirm your insurance and make an appointment.
Handicapped accessible.
