FOR PROVIDERS

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At Covenant Spine & Neurology, we take tremendous pride in making sure our community has access to high quality neurological care. We welcome referrals from all providers and clinics. We accept almost all insurance plans. Give us a call today to schedule an appointment or send a referral with our contact information below!

OFFICE HOURS

For information or to schedule an appointment, please call us at 336-761-4020

Monday – Thursday: 8:00 AM – 5:00 PM
Monday – Friday: 8:00 AM – 12:00 PM
Saturday & Sunday: Closed

PROVIDER FORMS

Covenant Winston Salem Referral Form
Covenant Kernersville Referral Form
Covenant Raleigh Referral Form

Referrals Contact Information by Location/Doctor

  • Kernersville – Dr. Alex Powers
    • Fax # – 336.761.4051
  • Raleigh – Dr. Allyson Bryant
    • Fax # – 706.223.0102
  • Winston Salem & King – Dr. Andreas Runheim
    • Fax # – 336.760.5510

PATIENT FORMS

New Patient Questionnaire
Return Patient Questionnaire
Patient Medication List
Patient PHI Contact List
Healthcare Consent & Authorization
Healthcare ROI Release & Authorization
Consent for Procedure & Disclosure
Post Procedure Instructions
Opioid Agreement
Financial Policy Statement
HIPPA Notice of Privacy Practices

Professional Memberships

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BOOK YOUR APPOINTMENT NOW!

For more information or to schedule an appointment, call us at 336-761-4020.

CONTACT US