Forms

The links below include forms to help you prepare for your first appointment at UPT.

Medical History Form

The existing medical history form is for patients coming to University of Physical Therapy who are not already established within the UNC Health Care system.

PDF document icon UPTmedicalhxform2012.pdf


Privacy Consent Form

Please review and complete this form if you have not received care in the UNC Health Care system within the past 12 months.

PDF document icon Privacy Consent Form.pdf


UNC Health Care Privacy Practices

The link address is: http://www.uncmedicalcenter.org/app/files/public/169/Notice-of-Privacy-Practice.pdf

 

My UNC Chart

Please use the link provided to establish your My UNC Chart account if you do not already have one.

The link address is: https://myuncchart.org/mychart/default.asp

 

UNC Health Care Medical Record Information

Please use the link below if you need to request any of your medical records.

The link address is: http://www.uncmedicalcenter.org/uncmc/patients-visitors/medical-records/