To make your office visit with Lady’s Island Medical Center go more smoothly, you may access patient forms in advance. Please print the forms listed below, fill them out completely and bring them with you to your appointment. In addition to the forms, you will need to bring the following:
- Driver’s License or a valid picture ID
- Insurance card(s)
- Relevant records from your referring doctor or emergency room visit
- X-rays, ultrasound, mammograms if requested by the provider
- New Patient Forms Overview
- Medical History Form
- Registration Form
- Record Release Authorization
- HIPAA Notice of Privacy Practices
- HIPAA Notice of Privacy Practices Acknowledgement
- Financial Policy
- Consent to Contact
Notice of Privacy Practices (NPP)
The Notice of Privacy Practices (NPP) describes how medical information about you may be used and disclosed and how you can access this information.
If you have questions, call us at 843-379-0367.