The following forms are for Duke Children's Cardiology of Raleigh patients. Print out the appropriate form and bring it to the office on your next visit.

New Patient Questionnaire

English (PDF, 87 KB)
Spanish (PDF, 94 KB)

New Prenatal Patient Questionnaire

English (PDF, 91 KB)
Spanish (PDF, 90 KB)

Returning Patient Questionnaire

English (PDF, 59 KB)
Spanish (PDF, 34 KB)

Returning Prenatal Patient Questionnaire

English (PDF, 59 KB)
Spanish (PDF, 157 KB)

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