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Patient Forms
If you have a new patient appointment with Dr. Jung at Northlake Neurology, please download
and print these new patient forms. Once completed, please fax them to 704-316-1848 or mail
them to: Northlake Neurology, 16525 Holly Crest Lane, Suite 120, 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.
(Please note our office number has changed to 704-316-5388.)
Welcome Letter
Patient Information/Consent to Treat
Notice to Our Patients
Financial Policy
New Patient Question Sheet
Privacy Form
If you have a new patient appointment with Dr. Jung at Northlake Neurology, please download
and print these new patient forms. Once completed, please fax them to 704-316-1848 or mail
them to: Northlake Neurology, 16525 Holly Crest Lane, Suite 120, 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.
(Please note our office number has changed to 704-316-5388.)
Welcome Letter
Patient Information/Consent to Treat
Notice to Our Patients
Financial Policy
New Patient Question Sheet
Privacy Form
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