New Patient Forms

Please Complete These Steps Before Your First Visit

Grand Strand Health & Wellness offers our patient forms online so they can be completed in the convenience of your own home or office.

If you do not already have AdobeReader® installed on your computer, click here to download.

Fax us your printed and completed forms or bring them with you to your appointment.

Step 1:
Application For Care

Please download, print & complete
the Application for Care form below.

Step 2:
About You - Online Form

Please fill out the online form.
Only fill up to the About You section.

For Personal and Work Related Injury Only!

If you are scheduling an appointment in regards to a personal or work injury claim, please download, print and fill out the form provided below.

Fax us your printed and completed forms or bring them with you to your appointment.

If you have questions or need help with these forms, call our staff at 843-357-9355