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We offer appointments up to three months in advance. Please provide the following information if you would like to request an appointment online. Based on the information you provide, you will be contacted by phone with an assigned appointment date and time. You may opt to submit your request, but a scheduler will contact you to verify the specific details . Please allow 24 hours (2 business days) for your request to be processed. If you have an urgent need to see us sooner, please contact us by phone at 919-781-5510.

We will check incoming appointment requests via email  
 at 11:00 AM and 3:00 PM Monday thru Thursday. 
Requests made after 11:00 AM on Fridays and on weekends 
will be picked up on the following Monday.


Patients Name

Date of Birth
Daytime Phone #
Street Address
City, State, Zip
Email address
Doctor Preference
(if any)
 
New Or Established Patient
New Established
Brief Description of Reason for Appointment
List Time/ Date Preferences
or Restrictions
Comments

 
     
 
 
     
 
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