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      • Weight Loss Surgery
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    • Call Coastal Carolina Bariatric and Surgical Center at (843) 875-8994
    • Contact Us
    • Directions
    • Health Portal
    • Pay My Bill
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          Coastal Carolina Bariatric & Surgical Center
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            Make an Appointment
            Call Coastal Carolina Bariatric and Surgical Center at (843) 875-8994
            Make an Appointment
            Directions
            • Home
            • Location
            • Our Services

              Our Services

              • Weight Loss Surgery
              • General Surgery
              • Reflux Surgery
            • Patient Center

              Patient Center

              • Patient Portal Support
              • Patient Portal
              • Patient Rights
              • Online Bill Pay
              • Telehealth Visits
              • Patient Forms
            • Meet Our Team
            • Getting Started
            • Contact Us
            • Directions
            • Health Portal
            • Pay My Bill

            Patient Forms

            • Coastal Carolina Bariatric & Surgical Center /
            • Patient Center /
            • Patient Forms
            • Patient Center
            • Patient Portal Support
            • Patient Portal
            • Patient Rights
            • Online Bill Pay
            • Telehealth Visits
            • Patient Forms

            Patient Registration Forms

            If you are a new patient, please fill out the registration forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment.

            Registration Forms

            • Financial Policy
            • Patient Registration and Consent
            • Medical Records Release
            • Patient HIPAA Acknowledgement and Consent
            Coastal Carolina Bariatric Center
            Coastal Carolina Bariatric & Surgical Center
            Coastal Carolina Bariatric and Surgical Center
            295A Midland Pkwy, Suite 260
            Summerville, SC 29485
            Phone: (843) 875-8994
            Fax: (843) 875-8981
            Contact Us
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            Copyright 1999-2025 C-HCA, Inc.; All rights reserved.
            Notice of Privacy Practices | Terms & Conditions | California Notice at Collection | Privacy Policy
            Social Media Policy | Acceptable Use Policy | HCA Nondiscrimination Notice
            Surprise Billing Protections | Cookie Preferences | Right to Receive Estimate | Accessibility | Disclosures