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Contact Information
Campus Box #3415
UNC-CH Dept of Pediatrics
Chapel Hill NC 27599-3415

 

Requiring signature only:
101 E Weaver Street
Suite 203
Carrboro NC 27510

919-843-9365

fax 919-843-9368

cmep@med.unc.edu

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Forms

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CMEP

  • Brochure
  • Program Guidelines :Covers examination procedures, use of forms, lab studies, photographs, case conferences, training, billing, and more.
  • CMEP Consent Form (Spanish version here)
  • Medical Report Form You have two options to submit your report for billing:
    1. Typed version - you may save a copy of the pdf template on your computer; type your responses; print the report; and mail the report to the CMEP office.
    2. Handwritten version - you may print a blank copy of the pdf template; hand write your responses; and mail the final report to the CMEP office.
    NOTE: We are not accepting electronic submissions of the CMEP report at this time.
  • Case Conference Report Form

CFEP