Pediatric Patient Self-Referral
By completing this form, you can start the process of working with us to decide on a plan that is best for the patient.
All messages (phone and online forms) are checked regularly during business hours. We will respond to each message. However, due to the high volume of incoming calls and messages we receive, we ask that you please allow up to three business days for our response.
Our online forms are sent to us via email. Because email does not provide a completely secure and confidential means of communication, please do not use this form if you wish to keep your communication private. Instead, call our main telephone number, 919-684-5301. For more information click the Duke and Your Privacy link at the bottom of this page.