Online Patient Registration

Online Patient Registration forms are provided as a convenience for patients who already have an established account & scheduled appointment with a BWC Physician. Please click the appropriate icon below to access your patient registration form. 

 

If you would like to become a new patient, please contact the desired office by visiting our Locations page.

Woman & Doctor
Adult Patient
Registration

For adults 18 years of age and older

Listening to baby's lungs
Pediatric Patient Registration

For children 17 years of age or younger

© 2020 Boice-Willis Clinic, P. A.

(252) 937-0200

Boice-Willis Clinic, P.A. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.  LEARN MORE >>

 

Language Assistance Available: Spanish (Español), Chinese (繁體中文), Vietnamese (Tiếng Việt), Korean (한국어), Tagalog-Filipino (Tagalog), Arabic (العربية), French (Français), German (Deutsch), Japanese (日本語), Vietnamese (ខ្មែរ ), Gujarati (ગુજરાતી), Hindi (हिंदी), Hmong (Hmoob)Russian (Русский)Italian (italiano).