Accessibility View Close toolbar

Online Forms

hereGrand Strand Health & Wellness offers our patient form(s) online so they can be completed in the convenience of your own home or office.

New patient

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Step 1:

Application for Care

Please download, print, and fill out the Application for Care form provided here. Once finished proceed to Step 2.

Download and Print Form


Step 2:

About You - Online Form

Please fill out the online form provided here. Please only fill up to the About You section.

About You


Step 3 (Personal/Work Injury Only):

Personal and Work Injury Form

Please download, print, and fill out this form provided here only if you have been in a work/personal injury.

Download and Print Form



Download the Free Adobe Reader®