Patient Documents

We prefer you utilize the patient portal but if you cannot please complete these documents.

Patient Registration Form click here

Designation of Personal Representative & Consent For Care and Treatment of a MinorĀ click here

Authorization for Release of Medical Records click here

HIPAA Acknowledgement and Designation Disclosure Form click here

HIPAA Consent Form click here

Office Policies click here

 

 

 

COVID-19 NOTICE

ATTENTION Patients!
Beginning Wednesday, March 25th, AAIR of Charlotte's clinic and shot hours will CHANGE to the following:

ELIZABETH:
Monday- Thursday 7:30-2:30
Fridays: 7:30-12:30
Last Shot given: 2:10 & 12:10 on Fridays
2nd & 4th Saturday of the month 8:30-1:30
Last shot given: 1:10

STEELE CREEK:
Monday & Wednesday 7:30-2:30
Last Shot given: 2:10

BLAKENEY:
Monday- Thursday 7:30-2:30
Fridays: 7:30-12:30
Last Shot given: 2:10 & 12:10 on Fridays
1st & 3rd Saturday's of the month 8:30-1:30
Last shot given: 1:10

Thank you for understanding during these ever-changing times and please stay safe! If you have any questions, please call our office at 704-910-1402 ext 320