NEW PATIENT FORMS
If you have not yet scheduled your appointment, please call 843-449-3668. Once you have scheduled your appointment, please complete the new patient registration forms (see below) and bring your insurance cards, photo ID, and list of any medications. All four new patient registration forms, found in the links below, must be filled out prior to your visit.
Online Forms
- Comprehensive HIPAA Acknowledgement Form
- Patient Financial Policy
- Patient Demographic
- Medical History
Printable Forms
If you are printing and filling out forms, we ask that you please arrive 30 minutes prior to your appointment so that we may have time to process your information.
- Comprehensive HIPAA Acknowledgement Form
- Patient Financial Policy
- Patient Demographic
- Medical History
Please Read Our Notice of Privacy Practices
Our Practice Accepts the Following Insurance:
- Blue Cross and Blue Shield of SC
- Blue Choice HMO
- Blue Choice Medicaid HMO
- Blue Essentials/Blue Option
- ACA Plans
- BCBSSC Federal
- State BCBS
- Cigna
- Humana/Choice Care Network
- Humana Medicare Advantage (No HMO)
- Medcost
- Select Health Medicaid HMO
- Molina Medicaid
- Molina Marketplace
- Tricare
- Tricare Prime
- United Healthcare
- Aetna
- New Hanover Health Advantage
- Clover Health