How To Become a Patient

Intial Visit

Payment & Insurance Info

Office Policies

How To Become a Patient

In order to receive integrative medical treatment at the Carolina Center, you first need to fill out the appropriate New Patient Registration Form - either Adult, Pediatric, or Autistic Spectrum Disorder. In order to download the form you need, click on the appropriate link below, then PRINT and fill out the form. You would then either mail or fax the form, or deliver it directly to the Center. (Note: Scheduling an Integrative Health Coaching session at the Carolina Center does not require that you fill out these forms or schedule an initial office visit with Dr. Pittman.) For Nutritional Education sessions, please fill out the Adult Registration form.

New Patient (Adult) Registration Form 

To be used for all individuals older than 18 years old.

New Patient (Pediatric) Registration Form

To be used for all children and teens up to 18 years old who are presenting for treatment of health issues other than Autism Spectrum Disorder.

New Patient (Autism) Registration Form

For all children or young adults with Autism Spectrum Disorder (which includes behavioral, social and speech delay).

Once we have received the completed form, we will be in touch to schedule your initial office visit. If you have any questions while you are reviewing or filling out the form, please contact the Carolina Center for Integrative Medicine's New Patient Coordinator:

Younger Mattox
919.571.4391  Ext. 101
ymattox@carolinacenter.com