• Patient Information Form
  

• Patient Medical History Form
  

• LHC Office Policies
  

• LHC Privacy Policy
  

• BCBS Questionare (Fill out for all BCBS Insurances)
  

• Consult Request Form For Referring Provider Use
  

Forms & Paperwork

"Providing the Very Best in Medical and Surgical Care for All Problems Involving the Hand & Upper Extremity"

Patients please fill out the first 2 forms (and the BCBS form if needed) and bring them to your appointment.  You can fax them too if you desire (843) 302-0644.  Please read the office and privacy policies as well, as you will have to sign them when you come in.

Disability Forms:

Insurance forms, disability forms, FMLA forms, etc. will be filled out on a first come first serve basis.  This may take 7 to 14 days.  Please plan accordingly.  There is a $15.00 per form fee due at the time the form is received by the office.  The form will not be completed until the fee is paid.

Legal Issues:

We do not bill third party liability companies/persons.  If your injury is the result of an accident and is pending law suit or settlement, we will bill you the patient and require full payment at the time of service.  We do not participate in lawyer arranged delayed payment agreements.