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SC Internal Medicine Associates & Rehabilitation, LLC is honored you have chosen us for your healthcare needs. Our team of board certified Physicians and Nurse Practitioners are dedicated to providing superior medical care to you and your family. The following information is designed to help you become more acquainted with our Practice. If you have any questions, please do not hesitate to ask. We are happy to help.

Please download, print and complete our patient forms below to save time during the registration process. Thank you in advance.
 




(please print forms and fill out completely prior to initial visit)

Patient Registration Form
Patient Registration Form - Spanish
Patient Health Summary
   
HIPAA Acknowledgement Form
   
Financial Agreement



(please print forms and keep for your files)

Notice of Privacy Practices



(print as needed)

Medical Record Release

 


 


(Current patient of South Carolina Internal Medicine)

Established Patient Form



(Currently NOT a patient of South Carolina Internal Medicine)

New Patient Form

 


 

Informed Consent Form
Health Summary Form