Before your visit
Patient forms
Filling these in at home means less time in the waiting room and a longer appointment with Dr. Hicklin. Print them, or download a PDF to fill in and bring with you.
Bring these to your first visit
- Your completed forms
- Your insurance card and a photo ID
- All of your medication bottles, including vitamins and supplements
- Any recent test results or records you already have
New Patient Registration
Your contact details, insurance, pharmacy, and emergency contact. Every new patient needs this one.
Medical History Questionnaire
Your symptoms, conditions, medications, surgeries, and family history — the background for your first visit.
Acknowledgment of Notice of Privacy Practices
A one-page acknowledgment that you received the practice's Notice of Privacy Practices, plus who we may share information with.
Authorization to Release Medical Records
Use this to have records sent to us from another provider, or sent from us to somewhere else.
Insurance & Financial Policy
How billing, copays, and no-shows work at this practice. Please read and sign before your first visit.
No printer?
That is not a problem. Come about fifteen minutes early and the front desk will give you the paperwork on a clipboard. Or call 803.324.4900 and we can mail the forms to you ahead of your appointment.
A note on privacy
These forms are not submitted through this website. Nothing you write on them travels over the internet — you fill them in on paper and hand them to the front desk, which is the most private way to do it.