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Handouts----------------------------------
Medical Record Transfer From Conner Clinic
Use this form to authorize a medical record transfer from Conner Family Health Clinic to another provider.
Medical Record Transfer To Conner Clinic
Use this form to authorize a medical record transfer from another provider to Conner Family Health Clinic.
Introduction to North Carolina Advance Directive
This document provides important information on North Carolina Advance Directives - Power of Attorney and Declaration of a Desire for a Natural Death.
(Click here for forms.)
Admission/Intake Form and Consent to Treat
This form must be filled out by all new patients to the Conner Family Health Clinic. Patients who have seen Dr. Conner at other clinics will still need to fill out this form on there first visit at this clinic. This form covers the basic demographic and insurance information as well as the consent to treat authorization and acknowledgement of receipt of the HIPAA privacy statement.
Insurance---------------------------------- Accepted Insurance Plans
This page details the insurance plans currently accepted by Conner Family Health Clinic.
(En Español)
Privacy----------------------------------
Health Insurance Portability and Accountability Act (HIPAA) Resources:
Health Links----------------------------------
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