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.

We would like to hear about your experience...

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.

(843) 497-5929