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919-761-5678

If you are a first-time patient at Heritage Urgent & Primary Care, you will be asked to complete patient registration forms. For your convenience, you may fill out the following forms, print them, and bring them with you in order to expedite your check-in.

Patient Registration Package

If you are unable to accompany your child or teen please fill out the following:

Treatment of Minors

ALL NEW PRIMARY CARE PATIENTS should have health history completed prior to your first visit.

Primary Care NEW PATIENT HEALTH HISTORY

Primary Care NO SHOW & CANCELLATION POLICY

620 Dr. Calvin Jones Highway, Suite 212
Wake Forest, NC 27587-3100

Phone: 919-761-5678
Fax: 919-761-5680

Email: info@heritageurgentcare.com