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Forms:
EVERY patient needs to fill out a complete form packet for the new Rivers Ave office.
New Patient Form Packet
Please fill out ALL forms and bring to your 1st appointment.
If you would like to fill out the fillable forms on your computer please download the link below and save to your device before filling out. Once completed, save the forms then attach and send via email to heatherbrush.haskins@gmail.com. You can also print the completed forms and bring to your 1st appointment.
Other Forms
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SC Disability Placard Form
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Drivers DOT Medical Exam Form
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Pre-Travel Consultation Form
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Controlled Substance Agreement
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Financial Policy
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HIPAA Form
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Medical Release Form
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New Patient History Form
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Personal Release of Information
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Practice Policies
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Credit/Debit Card Authorization Form
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Adult ADHD Questionaire
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