Patient Resources

New Patient Packet

There are two ways to submit the New Patient Packets- Electronically or Print.

To Print:
Download the new Patient Packet and complete on your phone, tablet or computer. Print out the form and bring to your appointment.

Download New Patient Packet

To Submit Electronically:
Download the new Patient Packet and complete on your phone, tablet or computer. Save the completed form to your phone, tablet or computer. Click on the submit button on our webpage and an email will open automatically addressed to our infobox. At that time you will need to attach the new patient forms from your phone tablet, or computer to the email.

Submit New Patient Packet

RecordS Release Form

Financial Policy

If you need any assistance,
please call the billing department at (336) 379-9708

Financial Policy

Notice of Privacy Practice

How Carolina Kidney Associates, PA protects your medical information.

Notice of Privacy Practice

Pay Your Bill

We accept all major credit cards.
Payments can be made with our payment portal.

Pay Your Bill

Patient Assistance Programs

Novartis Patient Assistance Foundation

Phone: 1-(800)-277-2254
Fax: 1-(855)-817-2711
P.O. Box 52029, Phoenix, AZ 85072-2029
Monday-Friday 8:00 a.m. to 8:00 p.m. Eastern Time Zone

Patient Assistance Foundation Enrollment Form
NPAF Application

Learn More About Novartis

Rayaldee (Calcifediol) Patient Assistance

Phone: 1-844-414-OPKO
Fax: 1-844-660-7083

Patient Assistance Program (PAP) Application for Rayaldee (Calcifediol) Extended-Release 30 MCG Capsules

Learn More About Rayaldee

Genentech Patient Foundation

Phone: (877) 436-3683
Fax: (833) 999-4363

Prescriber Foundation Form
Patient Consent Form

Learn More About Genentech