Patient Information - CarolinaEast Internal Medicine, PA

Whats New

You do not have to be referred to ECIM. You may call our offices and schedule an appointment. Patients with serious problems will be given an immediate appointment. Those requesting a regular appointment and physical will be scheduled as soon as possible. Unlike some practices, we file all types of insurance for our patients and accept VISA and MasterCard. We do request some form of payment at the time of your visit; however, our billing department will work with you to resolve financial responsibilities satisfactorily.

We also request that patients be aware of personal insurance requirements for pre-certification and payment.

GENERAL-INFORMATIONAL:

• Privacy Practices Policy
• New Registration Form
• HIPAA Authorization Form

RECORDS RELEASES:

• Medical Releases Records TO ECIM

• Medical Releases Records FROM ECIM

SLEEP CENTER:

• Sleep Study Information
• Sleep Study Instructions
• BP Questionnaire- Excess Sleepy
• The Modified Epworth Sleepiness Scale
• The Modified Epworth Sleepiness Scale for BP

PEDIATRICS:

• Kindergarten and Head Start
• Children's Medical Report
• New Patient Questionnaire
• Sports Physicals
• VADPRS pages
• VADTRS pages

MEDICAL AUTHORIZATIONS: