Grace Direct Primary Care
Dr. Nina Lucas
Accessible, Affordable, Quality Health Care
Call: (252)698-0345

Patient Forms

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all.

Patient Agreement Form

Medicare Opt-Out Agreement Form

 

 This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Office Location

  • Elizabeth City
  • 905 Halstead Blvd. Suite 29
  • Elizabeth City, North Carolina
  • 27909
  • Map & Directions
  • Call: (252)698-0345