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
	Patient Authorization for Disclosure of Protected Health Information to an Individual
	Financial Agreement
	BCBS Other Health Insurance Questionnaire
	BCBS Federal Other Health Insurance Questionnaire

(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