Main Street Health Center offers our patient form(s) online so you can complete it in the convenience of your own home or office.

• 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.

NEW PATIENT FORMS

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!  Please complete and bring these with you to your first visit, or even better, fax to us ahead of time with a copy of the front & back of your insurance card (if applicable) to 843-342-3367.

New Patient Intake Form

Download the Free AdobeReader®