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, (DO NOT SIGN or DATE the form) 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:  

We will not accept any forms that have be signed or dated prior to your office visit. Harris 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. 

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


General Forms:

New Patient Packet

Authorization to Disclose Health Information

Adult Patients' Authorization to Release Medical Records


Additional Forms by Specialty:

  
Family Care
    • Harris Family Care: Cullowhee Patient Packet

    • Harris Family Care: Franklin Patient Packet

    • Harris Medical Associates Patient Packet 

GI

 

Ortho & Sports Medicine
    • Harris Orthopaedics & Sports Medicine Patient Packet

Pediatric
    • Harris Pediatric Care Patient Packet

    • Pediatric Patients' Authorization to Release Medical Records 

Pulmonary
    • Harris Pulmonary & Sleep Center Patient Packet

Rehab Medicine

    Aquatic Therapy

       Dry Needling

Surgery
    • Harris Surgical Associates Patient Packet

Urology
    • Harris Urology Patient Packet

Women's Care
    • Harris Women’s Care Patient Packet

 


Financial Assistance Forms:

Financial Assistance/Charity

Financial Assistance Policy / Plain Language Summary*

Financial Assistance Application

Financial Assistance Forms Available for Harris Medical Associates, Harris Pediatric Care, Harris Women's Care and Swain Family Care.

It is the policy of Western Carolina Physician Practice Management, LLC., NHSC approved sites to provide essential services regardless of the patient’s ability to pay. Discounts are offered based on family size and annual income. 

Please Click Here for a Sliding Fee Discount Application

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.