EPILEPSY INSTITUTE OF NORTH CAROLINA
The Brain is ...  Where You Live
COMPREHENSIVE EPILEPSY PROGRAM                                           PATIENT CARE • EDUCATION • RESEARCH                                                  BEHAVIORAL HEALTH CENTER                                            THE BRAIN IS WHERE YOU LIVE

Registration Forms

Please download each of the forms listed below.  Print the forms needed, then mail or fax to our office.  You will need Acrobat Reader to view the forms below.                                                                      



YOU MUST BRING INSURANCE CARD
(Including Medicaid)

The Epilepsy Institute of NC accepts most major insurance plans.

No need to worry...the Epilepsy Institute of NC is here to help!

Call for an appointment

J. Christine Dean, MD
Co-Founder & Director
  North Carolina Licensed
  North Carolina Certified  Specialist


1311 Westbrook Plaza Drive, Ste. 100
PO Box 24458
Winston Salem, NC  27114-4458
(336) 659-8202
FAX:  (336) 659-8206