Your child can visit our clinic without a referral, but your insurance company might require one to cover the costs for care. Contact your insurer if you have questions about coverage.
So that we can have necessary information before seeing your child, we need to have you complete several forms. You can download and complete those ahead of time using the links below.
What to bring
- Your photo ID card
- The insurance card covering your child
- Your copay or payment in full if costs from your visit will not be covered by an insurance plan
- Recent test results that you received outside of Novant Health
- Medications your child is currently taking, including over-the-counter products
- Patient Information/Consent to Treat
- Authorization To Disclose Health Or Billing Information
- Communicating Your Health Information
- Pediatric History Questionnaire