EPILEPSY INSTITUTE OF NORTH CAROLINA
The Brain is ...  Where You Live
COMPREHENSIVE EPILEPSY PROGRAM                                           PATIENT CARE • EDUCATION • RESEARCH                                                  BEHAVIORAL HEALTH CENTER                                            THE BRAIN IS WHERE YOU LIVE

Patient Resources


Please click on link below to access all necessary forms to download, print and submit to EINC.  Thank you.

New patient registration forms

The Epilepsy Institute of North Carolina accepts most major insurance plans.

No need to worry...the Epilepsy Institute of North Carolina is here to help!

Call for an appointment

Dr. J. Christine Dean, M.D.
Co-Founder & Director
  North Carolina Licensed
  North Carolina Certified  Specialist


1311 Westbrook Plaza Drive, Ste. 100
PO Box 24458
Winston Salem, NC  27114-4458
(336) 659-8202
FAX:  (336) 659-8206
emial: info@eiofnc.org
Web based forms are provided below.  Please bear with us as we update our site to accommodate your needs. If the form you are looking for is not listed below; please go to registration forms page and download and print the forms needed.