Get New Patient Forms - Cardiovascular Institute Of The South

Completing the New Patient Forms for the Cardiovascular Institute Of The South is an essential step to ensure a smooth and efficient visit. This guide provides user-friendly, step-by-step instructions on how to properly fill out the forms online.

Follow the steps to complete your New Patient Forms online.

1. Press the ‘Get Form’ button to access the New Patient Forms, allowing you to open them in your preferred online editor.
2. Begin with the Patient Information section. Fill in your last name, first name, middle initial, and prefix as applicable. If you are completing the form for a minor, ensure to provide the guarantor information.
3. Complete the date of birth, Social Security number, and spouse's name if applicable. Indicate your sex, marital status, ethnicity, and race from the provided options.
4. List your preferred language and provide your physical address, mailing address, home telephone number, cell phone number, and email address.
5. Fill in your employment details including employer name, occupation, and work phone number. Don't forget to provide an emergency contact's name, phone number, and their relationship to you.
6. Indicate whether your visit is related to a worker's compensation claim by selecting 'Yes' or 'No.' Complete the Guarantor Information section if applicable.
7. Address the Insurance Information section by clearly printing the names of your insurance companies, policy numbers, and the policy owner's information if you're not the policy owner.
8. Review the Billing Policies. It's important to acknowledge your responsibilities regarding payment and present your insurance card during visits.
9. In the Patient Personal History section, state the reason for your visit and record any medication and non-medication allergies you may have.
10. Check any relevant past medical history conditions and review the systems list to indicate any current symptoms you may have.
11. Acknowledge receipt of the Notice of Privacy Practices and understand your consent for E-Prescribing by completing the necessary fields.
12. Sign and date the Patient Care Statement, ensuring you understand the importance of communication and follow-up in your treatment.
13. Finally, once all sections are filled out, save your changes, and review the document before downloading, printing, or sharing it.

Complete your New Patient Forms online today to ensure a seamless healthcare experience.