Printable Forms

Levine Cancer Institute-Albemarle is pleased to provide our patients with some of our most frequently used forms. For your convenience, you can download and print the forms at home, then fill out the information and bring it with you on your next visit.

Patient Forms

Release of Medical Records

Prescription Refills

Levine Cancer Institute-Albemarle PrescriptionsPlease bring all prescription medication to each appointment, even if prescribed by another physician. Refills or a new prescription may be requested during visits. All refill requests to our office must be made Monday through Friday (excluding holidays) during our normal operating hours of 8:30 a.m. to 5 p.m. We will make every attempt to address refill requests within 24 hours (or next business day) of the request.

If your prescription no longer has refills or expires before your next visit, please follow our three step process:

  1. Call 704-982-1880 for the Albemarle office  
  2. Ask to speak with your physician's nurse
  3. If you get voicemail, please leave your name, date of birth and the name of the drug to be refilled as well as drug store name and location

Please allow 24 hours' notice for all refills.

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