Appointments

Existing Patients

If you are an established patient and web enabled, please visit our patient portal (link below) to request an appointment.

RDC Patient Portal

Primary Care New Patient Application

If you are interested in becoming a patient of RDC, please fill out the form below and we will be back in touch with you as soon as possible.

Name:*
E-mail:*
Best Number to Reach Me:*
-
Street Address:*
City:*
Zip Code:*
Date of Birth*
Primary Insurance:*
Secondary Insurance:
Service Type:
Requested Primary Care Provider:
Current Primary Care Provider:*
Problem List:*
Current Medications:*
Additional Information:
I confirm the above information is complete and accurate:*
I understand that completion of this application is not a guarantee of my acceptance as a patient at Rowan Diagnostic Clinic, PA:*
Rowan Diagnostic Clinic, PA (RDC) may not accept new patients who are currently receiving multiple prescriptions for medications which are classified as Scheduled II-V controlled substances. In reviewing my application to receive medical services from RDC, RDC will access the North Carolina Controlled Substance Reporting System (System) to review any prescription history I may have regarding Schedule II-V controlled substances. By submitting this application, I authorize RDC to access my information in the System to assist in determining whether RDC will accept me as a patient:*