Carolina Medical Consultants, Rock Hill SC
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Dr. Randolph Villamor Dr. Rhea Hsu Dr. Matthew Jenkins Dr. John Hoitink Sheryl Lamb Dr. Randolph Villamor Dr. Rhea Hsu Dr. Matthew Jenkins Dr. John Hoitink Dr. Latessa Spiers
Form Downloads

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All patients are reminded to bring their driver's license and insurance cards to every visit

 

Patient and New Patient Forms: PLEASE PRINT AND COMPLETE THE FOLLOWING SIX FORMS AND BRING WITH YOU TO YOUR FIRST APPOINTMENT.

New Patient Demographic Form
New Patient Past Medical History Form
Notice of Privacy Practices Signature form
Financial Policy
Immunization / Prescription Policy and Consent Form
Release of Protected Health Information (PHI) to family release form

Medical Records Release:

Medical records to be release TO Carolina Medical Consultants
Medical records to be relased FROM Carolina Medical Consultants
Office Policies:

Full Notice of Privacy Practices / HIPAA Policy

Test Instructions:

DEXA

FAA and Air Traffic Controller Exam Forms:

Flight Physicals/ATC Exams

https://medxpress.faa.gov/

Important Information about your FAA/ATCS Exam – Please Read


311 Glenwood Drive, Rock Hill, SC 29732 · phone 803.366.7175 · fax 803.366.0529

COLA