Forms and Policies
Welcome to Reply! Please take a moment to review our new patient forms and policies. Before your first appointment, we request that you download and complete the required forms below and bring them with you on your scheduled appointment day. This will save you time upon arrival, however, if you are unable to complete forms in advance of your appointment, please plan to arrive 15 minutes before your scheduled appointment time to allow for this process.
- Reply Welcome Letter
- Patient Release of Information
- Patient Financial Responsibility
- Reply Cancellation/No Show/Late Arrival Policy
- Antepartum Welcome Letter (for obstetric patients only)
- Authorization for Release of Medical Information
Reply accepts insurance from many carriers. To see a list of current insurers, click here. If you have additional questions or concerns, please call us at 919.230.2100.
We look forward to serving you!
The Reply Health App
We us The Reply Health App to help you prepare for your appointments, share important messages about your health and make it easy for you to interact with us when you are at home. Click here to download pdf instructions for accessing the App
Reply now offers payment plans through CareCredit!
Pay Your Balance with CareCredit! We proudly accept the CareCredit credit card to help you finance your healthcare. Now you can use Pay My Provider, a new online payment solution from CareCredit, to pay outstanding balances quickly and securely. Special financing options are also available.*
Reply now offers access to your medical records through MediCopy!
We have partnered with MediCopy to fulfill your Release of Information requests and Disability/FMLA forms. MediCopy is fully HIPAA compliant and adheres to all state and federal regulations concerning release of medical information.
Patients can request copies of their medical records at no cost, but delivery fees apply for postage, so provide an email address! Please provide an email address on the authorization to expedite the process and delivery method. Records sent via email or to another provider are complimentary. Requests are completed within two (2) business days after receipt by MediCopy. To request your medical records please fill out one of the following authorization forms:
Forms are $30 for the first form and $15 for each additional form turned in at the same time. After payment is received, Disability/FM LA forms are completed and sent to the requester within three business days.
online chat: MediCopy.net I phone: 866-587-6274 I email: firstname.lastname@example.org