For your convenience, here are all the forms you'll need to become a patient at Southern Rapid Care. Please choose the correct New Patient and Medical History forms for Adults or Pediatrics. And if you need assistance, please give us a call: 251-974-2273
New Patient Registration Form (Adults):
New Patient Registration Form (Pediatrics):
Patient Medical History (Adults):
Patient Medical History (Pediatrics):
Authorization to Release Medical Information:
Southern Rapid Care's Missed Appointment Policy:
Southern Rapid Care's Memorandum of Understanding:
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