Patients
New Patient Forms
Save time at check-in. Download, print, and fill out our registration and privacy forms in the comfort of your own home, then bring them with you to your visit.
Patient Registration Packet
The registration forms we need to set up your visit. Fill out every page and bring the completed packet with you.
Consent Form
Our HIPAA and treatment consent form. Please review, sign, and bring it with you to your visit.
Privacy Notice
Our Notice of Privacy Practices explains how we use and protect your health information. Please read it before your visit.
Medical History
Your patient history form. Complete and sign it so our providers have the information they need to care for you.
Download, print, and bring your completed forms with you to your visit.
Before Your Visit
- Complete the Patient Registration Packet and the Medical History form.
- Sign the HIPAA and Treatment Consent Form.
- Read our Notice of Privacy Practices.
- Bring the completed forms with you to any Southern Immediate Care location.
Questions about our forms? Call us at (205) 409-2794.
