Please download all the required forms by clicking on the links below:

Patient Registration Form

Medication History Form

Financial Policy

Consent Forms

Credit Card On File Authorization

Please bring the completed and signed forms to your appointment. Completing these forms prior to your arrival will help expedite your care. New patients should arrive 30 minutes prior to appointment time to ensure all documentation is complete.

Thank you for allowing us the privilege of providing your care.


Our office is open Monday-Friday, 8:00 AM to 5:00 PM. We are closed on most major Holidays.



Patients are seen by appointment only. To make an appointment, please call our office between the hours of 8:00 AM and 5:00 PM, Monday through Friday.

Preparing for Your Visit:

 Please bring your insurance card and a photo ID.

 Bring a list of your current medications, including over-the-counter products & supplements.

 Please remember to have your referring physician’s office fax your medical records prior to your visit.

For Diabetic Patients:

Please complete these items 1-2 days before your appointment—

Download your glucometer readings or bring a written log.

If you have a pump, download your current pump settings and download your pump or sensor results.



If you have been referred for care by another health care provider, please ask your provider to send us the referral using the Infina Connect Referral Management system.  If your provider’s office does not use Infina Connect, you may download this form for your provider to complete and fax to (919) 954-3365.



Our goal is to provide excellent care to each patient in a timely manner. If it is necessary to cancel an appointment, patients are required to call or leave a message at least 24 hours before their appointment time. Notification allows the practice to better utilize appointments for other patients in need of prompt medical care.

A “no-show” means any patient who fails to arrive for a scheduled appointment.  A “same-day cancellation” means any patient who cancels an appointment less than 24 hours before their scheduled appointment.  Note: Monday appointments must be canceled by noon the preceding Friday to avoid the same-day cancellation fee.  The fee for a “no-show” or “same-day cancellation” will be $100.00 for new patient appointments and re-consultations, and $75.00 for follow-up visits.

As a courtesy, we attempt to contact every patient with an appointment reminder phone call and/or text message. However, it is the responsibility of the patient to arrive on time.  A late arrival means any patient who arrives more than ten (10) minutes after the scheduled appointment time.  If you arrive late for your appointment, you may be asked to reschedule.



Prescription refill requests will not be processed by phone. Please have your pharmacy send us an electronic refill request if you need a refill between office visits. Please allow at least 48 hours for medication refills to be processed.

Prior to your scheduled office visit, please look over all your medications to determine if you need to request refills during your visit.

All medications will require regular follow-up visits at intervals to be determined by your provider. You should receive refills of your medications at each visit that will last until you are due to return.

If you are overdue for your visit, your provider will provide enough medication to last until your scheduled appointment. This courtesy refill is at the discretion of the provider and does not apply to all medications.



We are happy to provide prior authorizations for medications or procedures your provider feels are medically necessary. Please allow our staff 2-3 business days to submit these requests.

Note: It may take your insurance plan five (5) business days to respond.  To check the status of a prior authorization, please contact your insurance carrier directly



Raleigh Endocrine Associates is provided limited samples by pharmaceutical companies. The purpose of these samples is to give providers the ability to initiate new treatment and determine the appropriateness and dosage of treatment for each particular patient. Samples are not provided with the intention of replacing your pharmacy.
Raleigh Endocrine Associates has also seen the number and quantities of medications drastically reduced by all pharmaceutical companies. Therefore, all samples will be given to initiate new therapies at the time of visit only.

Raleigh Endocrine Associates will not be accepting phone calls or walk-in requests for samples.



Test results may take up to 10 business days. All results may be viewed in the Patient Portal as soon as they have been reviewed and released by your provider. If you have not set up your Portal account, please call our office and we will be happy to assist you.  Lab results may post individually to your account and without notation. Please make sure you read any accompanying messages as they will contain the instructions from your healthcare provider.

You may also be contacted by phone. If you have not received your test results via the Patient Portal within two weeks of your test and have concerns, please call the office for assistance. If you have any further questions once receiving your results please do not hesitate to call.

Please note: Replies to posted lab results within the Portal are not set up to return to our office and will not be received.  Please use the Portal secure messaging feature instead.



We will release Medical records with a written authorization only. Medical forms that require a provider signature are subject to a $20-$60 fee.

Please download this form, complete, sign, and mail or fax to our office at (919) 954-3365.