Patient Forms-Resources - Select Health of the Carolinas

704-541-5555

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Patient Forms and Resources

Current Notices-Click to Read

Click or Tap the Form Photo Below for Documents Related to your New Patient Appointment.
(Additional forms may be required during your in-office appointment.)

If the forms do not open, downloading Adobe may be necessary.
We have provided a link near the bottom of this page to assist you.

New Patient
Intake Forms

Click to Download

Patient
Portal

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Select Health
of the Carolinas

Focused on Healthcare Solutions

Address: 15720 Brixham Hill Ave Suite #130 Charlotte, NC 28277

Phone:

(704) 541-5555

Ballantyne
Corporate Park

Re-Order
MediNox Pro Here

DISCLAIMER: Like all aspects of healthcare, Select Health of the Carolinas treatments have a success and failure rate. Patient experiences expressed on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else. Select Health of the Carolinas (Joe D. Haines, Jr, MD, Eric M. Shapiro, DC ) has made no guarantees or warranties with respect to the information contained on this website and has made no guarantees as to individual results, as they may vary. If you decide to purchase additional treatment, you have the legal right to change your mind within three days and receive a refund.

Patient Forms and Resources

Current Notices-Click to Read

Click or Tap the Form Photo Below for Documents Related to your New Patient Appointment.(Additional forms may be required during your in-office appointment.)

If the forms do not open, downloading Adobe may be necessary. We have provided a link near the bottom of this page to assist you.

New PatientIntake Forms

PatientPortal

Click or Tap the Form Photo Below for Documents Related to your New Patient Appointment.
(Additional forms may be required during your in-office appointment.)

If the forms do not open, downloading Adobe may be necessary.
We have provided a link near the bottom of this page to assist you.

New Patient
Intake Forms

Patient
Portal