New Patient Information

If you are a new or returning patient, you will be asked to provide information about yourself and the reason for your visit.

Patient Portal

Patients can now view history, schedule appointments, request prescription refills, make payments, and more...

Patient Satisfaction Survey

The people of Carolina Health Specialists facilitate healthier lives wherever we serve.

If you are a new or returning patient, you will be asked to provide information about yourself and the reason for your visit. Some physician practices might refer you to their practice website and request that you print out and complete the patient information forms and bring them with you to your appointment. Other physician practices may request that you fill out the forms upon your arrival.

Providing personal information ensures that your medical record is accurate and up to date and contributes to your diagnosis and treatment by your physician. The information we will request includes (but is not limited to):

Information we may request includes but is not limited to:
  • Name
  • Address
  • Telephone
  • Employer name,address and telephone number
  • Medical insurance carrier
  • Spouse name, employer, insurance carrier (if applicable)
  • Authorization for use and/or disclosure of protected health information (medical records)
  • Current list of medication
  • Prior injuries/illnesses
  • Consent for evaluation and treatment
  • Personal health questionnaire
  • Other relevant information
Keeping your personal information safe and secure is extremely important and our highest priority along with helping you to achieve and maintain good health. That is why we will never release your personal information without written authorization.

For new patients, click here to Login to our Patient Portal to create your patient account.