Coastal Medical
Exceptional Care for Patients. Exceptional Careers for Physicians.

Coastal Medical Patient Forms

Please see below for several forms that may be helpful to you as a Coastal Medical patient.

Request for Medical Records

Click to Request Your Medical Records Online

Coastal offers an online patient record request for the following individuals to request patient records:

  • Patients requesting their own records
  • Parents of minor patients requesting records
  • Caregivers acting on behalf of a patient (i.e. Power of Attorney)

Requests for patient's medical records will be billed to the patient according to state regulations.

Printable Version - Medical Record Request Form (PDF)