Carolinas HealthCare System
Locations and Hours

Rutherford Pediatrics Patient Forms

This packet is available for download; please review and complete before your first visit.

  • New patient forms (PDF)
    Included in this packet:
    • Pediatric Patient Registration, and
    • Authorization for Release of Health Information

Privacy Practice Forms:

About Carolinas HealthCare System
Who We Are
Community Benefit
Corporate Financial Information
Diversity and Inclusion
Annual Report
Patient Links
Pay Your Bill
Hospital Pre-Registration
Patient Rights
Privacy Policy
Financial Assistance
Quality & Value Reports
Join Carolinas HealthCare System
Physician Careers

For Employees
Carolinas Connect
Connect with Us
Watch Carolinas HealthCare on YoutubeFollow Carolinas HealthCare on TwitterLike Carolinas HealthCare on FacebookContact Carolinas HealthCareJoin Carolinas HealthCare on LinkedInGo to our mobile website.