New Patient Forms

Download, Print, and Bring With You.

You have the ability to download, print, and fill out our registration and privacy forms in the comfort of your own home. Please complete the Patient Registration Form, Patient History Form, Notice of Privacy Practices and the HIPAA and Treatment Consent Forms and bring them with you to your visit.

PATIENT REGISTRATION PACKET
CONSENT FORM
PRIVACY NOTICE
MEDICAL HISTORY

Southern Immediate Care, Locations, contact
new patient forms
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