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New Patient Forms

CMC Orthopaedic Surgery provides new and existing patients the following forms for download to fill out and bring to your appointment as requested.

CMC Orthopaedic Surgery Wait LoungeAbout Your Appointment


Prior to your appointment, please do the following:

  • Medical History Questionnaire: Fill out the questionnaire and bring it with you on the day of your visit. Please pay particular attention to the Medication History section of this form.
  • Previous records: Have your referring physician fax all your previous records prior to your visit. Records should include office notes, lab work, radiology results, any procedure notes and pathology pertinent to your care.
  • Specialist insurance authorizations: If your insurance company requires an authorization or referral for a specialist visit, please ensure that your primary care physician provides this information to us.

Please bring the following with you to your appointment:

  • Current insurance card and appropriate co-payment
  • X-rays, CT scans, and MRI scans related to your health concern for which you are being treated. Please note that these are the actual films of these scans, not only the results.


What Will Happen at Each Visit

Prior to each appointment you will be asked to sign-in at the registration window and provide your insurance card. During registration, you will be asked questions about your address, telephone number, insurance, etc. We ask these questions on each visit to make sure we have the most up-to-date information in case we need to reach you about appointment changes, lab results etc.

Once you have been registered, the nurse will call you to the clinical triage area based on your appointment time. The nurse will take your temperature and blood pressure and ask you about your allergies, medications you taking and the pain you may be experiencing. After the nurse has finished, the provider will see you. We do see patients in order of appointment time for each individual provider.

Once you have seen the provider, you will be checked-out where you will be given information on future office appointments, if needed.

Please provide us with any feedback regarding your visit at that time so we may make our customer service better.

Due to the complexity of the conditions that require surgery, our physicians are dedicated to providing adequate time with each patient to address all their clinical needs. Please be aware that you may experience a wait in our office, so please bring activities for your entertainment. Some of the amenities we provide for your comfort include: refreshments, television, assortment of magazines, and free guest wireless Internet.



You will park in the Morehead Medical Plaza Parking deck, adjacent to the office building. Please bring your parking ticket and we will validate at registration.


Arriving Time

Please arrive to your appointment ten to 15 minutes early. If you are late, you may not be seen right away. If you are significantly late, you will be seen after all of the on-time patients.


Calling With Questions

We hope to answer all your questions during your visit with our physicians, but if you have questions after, please contact our office during normal business hours. If you have a question that requires immediate attention, please do not leave a voice mail. Press "0" and ask the receptionist to contact the nurse for you.


After-hours Calls

You will get an operator when you call our office before 8 a.m. or after 5 p.m. If you are ill, the operator will either have you talk with a nurse right away or have a nurse or physician call you back.

If you have an emergency, please call 911 or go to the nearest Emergency Room.


Medications and Prescription Refills

During your visits with us, our providers do not review in detail the medications that your primary care provider (PCP) has already prescribed to you. Our physicians will discuss with you and answer questions about any medications they prescribe for you.

If you need a refill on a prescription and the prescription has not run out, please call your pharmacy. For refills on prescriptions that are running out, please call our office at least three business days before you exhaust your medication supply. Your call will be sent to your physician's nurse line. Please leave a message with your name (spelled out), date of birth, your medication (spelled out), your return number and the pharmacy you use. We will call you back after we contact your pharmacy.

If you are coming to see us and have prescriptions from other physicians (such as your primary care physician), please note that any refills will need to be obtained from the physician who originally prescribed the medication to you. We will not be able to refills prescriptions that another physician prescribed to you including pain medications.



If you have a form that needs to be filled out for medical leave, return to work excuses, or disability applications, etc., drop the form off at our office. Please remember to complete all patient demographic sections on the form. We will ask you at that time how you would like us to get the form back to you, and we will fax, mail or leave the form at the practice for pick-up. If you want us to fax or mail, you must have the fax number or address at the time of drop-off. If you have this form at your initial visit that would be the best time to leave it with the nurse.


Insurance Questions

There are several things to check about your insurance before you come to each visit.

Managed Care/Commercial Insurance: If you have managed care/commercial insurance (Blue Cross-Blue Shield, MedCost, Aetna, Cigna, etc.), you may have co-payment due at the time of your visit. If you do not know if you have a co-payment or how much it is, call the insurance customer service number on the back your card and find out. If you plan to pay your co-payment in cash, bring the correct amount or smaller bills. We often cannot make change for large bills such as $100 bills.

Medicare: Our practice does not accept all forms of Medicare. We will accept the standard plan. If you have this, your card will be red, white and blue. We do not accept Medicare Advantage. In this case, your insurance card may read HMO, PPO or have the name of a commercial insurance company. If you have any questions, please call the customer service number on the card and ask your insurance representative or you can call our office at 704-446-2772 for CMC Orthopedics - Charlotte and 980-212-6250 for CMC Orthopedics - Lincoln and provide your card number and we will look this up for you.

Medicaid: Look at the box at the bottom left-hand corner of your card. If there is a line filled out inside the box, the Medicaid office thinks you have another insurance carrier. If you do not, call your Medicaid caseworker and let them know.

No Insurance: If you do not have any insurance or your insurance is no longer active, then, we will need a $50.00 deposit at the time of the visit. This is not all that you will owe. You will be billed for the remainder of the charges.



We cannot give your information to anyone other than yourself. If someone will be meeting you at our office and you want them to go into the exam room with you and they have not arrived before you are called back to the exam room, please let us know at the front desk to expect your guest.

If you need a copy of your medical records, we will need you to complete a form, authorizing us to release your records to you and/or your family. We are happy to provide this form to you if needed.


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