Welcome to Wake Internal Medicine Consultants, Inc.

Patient Forms - Wake Internal Medicine

Patient Forms

For your convenience, please find our most commonly used Wake patient forms below. Patient Registration Form Medical Records to be Sent to Wake Internal Medicine (WIMC) Medical Records to be released from WIMC & Sent to Another Facility Medical History Form Medication List For Wake Patients COVID-19 Antibody Test Waiver Mammography Forms

Wake Internal
Wake Gastroenterol
Wake Women's Health
Wake Sport Medecine

Main Location

3237 Blue Ridge Rd.

Raleigh, NC 27612

Phone: (919) 781-7500

Fax: (919) 645-3054

Monday - Friday: 8:00am - 5:00pm

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North Raleigh

10880 Durant Rd, Suite 100

Raleigh, NC 2.7614

Phone: (919) 781-7500

Fax: (919) 420-6065

Monday - Friday: 8:00am - 5:00pm

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