Cornerstone Pediatric and Adolescent Medicine

General Pediatrics and Adolescent Medicine

 
Patient Services
Contact Information
Cornerstone Pediatric and Adolescent Medicine
97 Cornerstone Drive
Cary, North Carolina 27519

919-460-0993
919-481-3952 (fax)

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Online Forms

Please print and fill out the following forms to bring along on your first office visit!

FLU CLINIC FORM-FILL OUT ONE PER PATIENT AND BRING TO FLU CLINIC
FLU VACCINE INFORMATION SHEETS 2010-11--READ PRIOR TO FLU CLINIC
2010 Patient Registration form
Patient Questionnaire
RECORDS RELEASE FORM
HIPAA (Health Insurance Act of 1996)
HIPAA PRIVACY DIRECTIVE FOR MINORS
HIPAA PRIVACY DIRECTIVE FOR THOSE OVER 18 YEARS OLD

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KINDERGARTEN FORMS

KINDERGARTEN ENTRY FORM

SPORTS PARTICIPATION FORMS

 

 

HIGH SCHOOL SPORTS PARTICIPATION FORM
MIDDLE SCHOOL SPORTS PARTICIPATION FORM

Patient Education Resources

LINKS:

QUESTIONNAIRES:

6 Month Development Questionnaire
12 Month Development Questionnaire
18 Month Development Questionnaire
24 Month Development Questionnaire

Frequently Asked Questions



Staying Healthy


Fun Sites for Kids, Teens and Parents


We Accept the Following Insurances

Aetna,  Blue Cross/Blue Shield, Cigna, Great West, Medicaid, United Healthcare, and many more.

Contact us at 919-460-0993 to confirm we accept your specific insurance.