Download and print the New Patient Registration Form and bring it to your scheduled appointment. We look forward to seeing you!
New Patient Registration Form (English)
New Patient Registration Form (Spanish)
HIPPA Form (English)
HIPPA Form (Spanish)
Medical Record Release Form
Surgical/Procedure Release Form
Andrew Tate is a native to Dobson, NC. Serving as Vice President of Ambulatory Services and Chief Practice Officer, his mission is to provide exceptional service and access to healthcare in our community. Having worked for the organization for more than 10 years, he has a background in Occupational Therapy and most recently served as Executive Director for Yadkin Valley Home Health. During his time at Yadkin Valley Home Health, the agency recognized significant success including awards from strategic healthcare programs as being in the top 5% for patient satisfaction on a national level. The agency operates out of Jonesville, NC and serves 10 counties. Andrew enjoys spending his free time boating with his family and his German shorthaired pointer. Andrew has a Bachelor’s and Master’s Degree from Lenoir Rhyne University in Human Occupational Studies and Occupational Therapy, respectively. Andrew also completed a Master in Health Administration from Appalachian State University.
Mary Blackburn brings more than 30 years of healthcare management experience to her role at Hugh Chatham Memorial Hospital. Mary has been at the forefront of Hugh Chatham’s focus on sustainability through innovation as she has been the primary leader in support of acute care services, surgical services, patient experience, provider recruitment and contracting, as well as overseeing system-wide regulatory compliance and risk management, and leading strategic initiatives focused on growth and care transformation. She serves on various boards at the local, regional, and state level to further the affordability, accessibility, and quality of healthcare in North Carolina.
Mary has an extensive clinical background as a licensed emergency and trauma care nurse and as a nursing instructor. During her time in the U.S. Army, she attained the rank of Captain and held nursing leadership positions at Fort Sam Houston in San Antonio, TX, at Walter Reed Army Medical Center in Washington, DC; and at Eisenhower Army Medical Center at Fort Gordon in Georgia.
Mary is a Fellow in the American College of Healthcare Executives. She holds a Bachelor of Science in Nursing from Georgetown University and a Master of Science in Nursing from Duke University. When she’s not working, Mary is an avid reader and enjoys travel and outdoor activities with her husband and five children.
Paul Hammes brings more than 25 years of healthcare experience to his role as Chief Executive Officer at Hugh Chatham Memorial Hospital. A Fellow in the American College of Healthcare Executives and an Army veteran, Paul serves on the boards of: the North Carolina Healthcare Association; the Southern Atlantic Healthcare Alliance; Telios Collaborative Network; Mountain Valley Hospice and Palliative Care; Alleghany Health; and, on the Healthcare Management Advisory Board at Appalachian State University, where he has served as Adjunct Faculty.
Hammes holds Master’s and Bachelor’s degrees from the University of Georgia and completed an executive fellowship at UNC Chapel-Hill. When not spending time with his family, Paul enjoys collecting and playing guitars.
Kent brings more than 30 years of healthcare financial management, consulting and operations experience to the Chief Financial Officer role at Hugh Chatham Memorial Hospital in Elkin, North Carolina. In his role as CFO, Kent will be responsible for leading the finance organization and key supporting functions, including accounting, revenue cycle, treasury, internal audit, MIS/HIM, and materials management, as well as facilities support. He has served in key financial positions at several North Carolina hospitals and most recently served as a Senior Manager with DHG Healthcare Consulting, serving a wide variety of healthcare organizations throughout the southeastern United States. Kent is a Fellow of the Healthcare Financial Management Association and actively serves at both the National and North Carolina Chapter levels. He holds a Bachelor of Science in Accounting from North Carolina State University. When not working, Kent serves on the board of the Community Clinic of High Point and enjoys the outdoors and spending time with family.
Dr. Jonathan Snyder is a Board certified in orthopedic surgery and a Fellow in the American Academy of Orthopedic Surgeons. A native of Elkin, Dr. Snyder earned a biology degree with distinction at Duke University prior to completing medical school at Wake Forest University, then returning to Duke for a residency in orthopedic surgery. Dr. Snyder joined Tri-County Orthopedic and Sports Medicine and the Hugh Chatham medical staff in 2009. He served as Chief of Surgery from 2014-2017 and as Chief of the Medical Staff since January of 2018.