WCNC will be closing both offices at 3pm on Friday July 26th for a staff event

Patient Forms

Patient Forms at WCNC

Patients can print and fill out their forms or arrive 20 minutes prior to their appointment time.

If you are a new GYN patient please complete interactive form, print and bring to your appointment. New GYN Patient Forms. If you are a new patient coming for an annual exam, breast problem or ovarian problem, AND are age 25 or greater you will need to fill out the Family History Questionnaire in addition to the New Patient Forms.

New GYN Patients:

Newly Pregnant Patients:

Postpartum Patients:

Mammography patients:


If you are requesting that your medical record be sent to or from a referring provider: