New Patient Registration

Would you like to save time at your visit?

Now you can select and print the necessary forms for your upcoming visit. You may complete the forms anytime before your appointment and give them to the check in patient representative when you arrive for your appointment.

*On the day of your appointment please arrive 15 minutes early and remember to bring all forms, any insurance cards and medication information with you.

Click on the appropriate link and a form screen will open. You may print the form on the screen and fill it out, each form can be filled out online and printed. Make sure you remember to give any forms to the receptionist when you come in for your appointment.

We require that each new patient have a registration and health information disclosure form, these forms are included in the New Patient Packet.

Please Note:  Haywood Medical Group is proud to offer our patients a variety of services, in order to deliver the best care for you and communicate with you regarding appointments it is necessary that we keep all of your information up-to-date. To help us serve you better we will ask that you verify your contact and insurance information at every appointment check-in.  Additional information is also available once you are signed up for the Patient Portal. 


General Forms:

New Patient Packet

Authorization to Disclose Health Information

Adult Patients' Authorization to Release Medical Records


Additional Forms by Specialty:

  
Cardiology
    • Western Carolina Cardiology Patient Packet

Family Care
    • Haywood Family Care- Canton Patient Packet 

    • Haywood Medical Associates Patient Packet

    • Mountain Medical Associates Patient Packet 

    • Waynesville Family Practice Patient Packet  

Orthopaedics
    • Western Carolina Orthopaedic Specialists Patient Packet

Pediatric
    • Mountain Pediatric Group Patient Packet 

    • Pediatric Patients' Authorization to Release Medical Records 

Spine Care
    • Mountain Spine Care Patient Packet

Surgery
    • Haywood Surgical Associates Patient Packet

Thoracic & Vascular
Urology
    • Blue Mountain Urology Patient Packet

Women's Care
    • Haywood Women’s Medical Center Patient Packet

English and Spanish versions if we have them available

 


Financial Assistance Forms:

Available for ...

Financial Assistance/Charity

Financial Assistance Policy / Plain Language Summary*

Financial Assistance Application

*Acrobat Reader is required to view these files. If you do not have this program, download it free at www.adobe.com/reader/.

 

If you have any questions or comments, our staff is available to assist you Monday-Friday from 8:00 a.m. - 5:00 p.m.