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.



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.



As a courtesy, we attempt to contact every patient to remind them of their appointment. However, it is the responsibility of the patient to arrive on time. If you arrive more than 10 minutes past the scheduled appointment time, you may be asked to reschedule. If you are unable to make a scheduled appointment, please notify us as soon as possible, as we reserve the right to charge for visits cancelled with less than 24 hours notice. Patients who do not cancel their appointments at least 24 hours in advance will be charged a “No-Show” fee. The no-show, or same-day cancellation, fee for new patients and re-consultations is $100. The no-show or same day cancellation fee for regularly scheduled follow-up visits is $75.  Monday appointments must be canceled by noon the preceding Friday to avoid the cancellation fee.



Please ask your pharmacy to send us an electronic refill request. This will be the fastest way to get your prescription refilled. Please allow two business days for us to process the request. To check the status of a prior authorization, please contact your insurance carrier.  If the insurance carrier has not received our prior authorization request and it has been more than 48 hours, please send us a message through the Patient Portal.



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. There may be a charge for each request according to North Carolina statute. Medical records fees are $30. 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.