Patient Forms
If you have a new patient appointment with Dr. Jung or Dr. Robles at Northlake Neurology, please download and print these new patient
forms. Once completed, please fax them to 704-316-1848 or mail them to: Novant Health Neurology - Northlake, 10305 Hamptons Park
Drive, Suite 101, Huntersville, NC 28078.
These forms will need to be faxed or mailed to our office PRIOR TO your appointment.
If your appointment is within the next 2 days, please complete the forms and bring them with you to your appointment, as that they will not
arrive on time if you mail them.
Consent to Treat
Financial Policy
Privacy Form
Medical Records Release Form
If you have a new patient appointment with Dr. Jung or Dr. Robles at Northlake Neurology, please download and print these new patient
forms. Once completed, please fax them to 704-316-1848 or mail them to: Novant Health Neurology - Northlake, 10305 Hamptons Park
Drive, Suite 101, Huntersville, NC 28078.
These forms will need to be faxed or mailed to our office PRIOR TO your appointment.
If your appointment is within the next 2 days, please complete the forms and bring them with you to your appointment, as that they will not
arrive on time if you mail them.
Consent to Treat
Financial Policy
Privacy Form
Medical Records Release Form
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| Copyright 2017 Northlake Neurology. All rights reserved. |