SHAE Medical, PLLC
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    • Home
    • Services
    • About Us
    • New Patients
    • Contact Us
    • Patient Resources
    • COVID-19
    • Education
    • NEWS
SHAE Medical, PLLC
  • Home
  • Services
  • About Us
  • New Patients
  • Contact Us
  • Patient Resources
  • COVID-19
  • Education
  • NEWS

Interested in becoming our patient?

 Please complete our registration below and we will be in touch within 4-5 business days to discuss clinician availability and to schedule your appointment. 


Please know that your privacy and online security is important to us. Your information is submitted through a secure and HIPPA compliant server. 

New Patient Online Registration, Consent, and Medical History

Facility Administrator: Interested in our services?

We are honored to be considered a part of your resident's medical care team.  Please complete the below information and our staff will be in touch to coordinate clinician availability and how we can partner to support your resident's medical care needs.


New Facility Request Form

Forms

Please use our electronic form links (found above) for online submission for the most timely processing and registration. 


You may also download our New Patient Registration Packet or other individual forms needed and submit via:

  1. Mail : 5306 NC Highway 55, Suite 105,  Durham, NC 27713
  2. Fax: 919-679-7112
  3. Email: info@shaemedical.com

New Patient Registration (Includes all forms needed) (pdf)Download
Notice of Privacy Practices & Client Rights and Grievance Policies (pdf)Download
SHAE Medical Health Insurance Portability and Accountability Act (HIPPA) Policy (pdf)Download

SHAE Medical, PLLC

5306 NC Highway 55, Suite 105, Durham, NC 27713-7812

Phone: 919-646-4858 FAX: 919-679-7112

Copyright © 2021 SHAE Medical, PLLC - All Rights Reserved.

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