Coastal Medical
Exceptional Care for Patients. Exceptional Careers for Physicians.
URL COPIED!
Coastal Medical Patient Forms
Please see below for several forms that may be helpful to you as a Coastal Medical patient.
- New Patient Forms Packet - Adult and Family (PDF)
- Notice of Privacy Practices - HIPAA (PDF)
- Advance Care Planning:
- Permission to Discuss (PDF)
- Request for Medical Records - New Patients (PDF)
- Request for Medical Records - from Coastal Medical (PDF)
- Pediatric Patient Information (PDF)
- Pediatric Medical History Form (PDF)
- Pediatric Stimulant Medication Agreement (PDF)
Request for Medical Records
Requests for patient's medical records will be billed to the patient according to state regulations.
Online Forms for Requesting a copy of Medical Records
- Patient Online Access Form - for individual patients or their legal guardians to request medical records.
- Third Party Request Portal - for healthcare providers, attorneys or those requesting the medical records of someone other than themselves (and who are not the legal guardian).
Print Version
Coastal Medical
-
Locations
-
Adult Medicine
- Cranston Primary Care
- East Greenwich Primary Care
- East Providence Internal Medicine
- Garden City Primary Care
- Greenville Internal Medicine
- Lincoln Primary Care
- Metacom Primary Care
- Newport County Primary Care
- Newport Primary Care
- Providence/Edgewood Primary Care
- Wakefield Primary Care
- Warren Avenue Primary Care
- Women’s Medicine Collaborative Primary Care
- Family Medicine
- Pediatric Medicine
- Specialties
- Laboratory Services
-
Adult Medicine
- Coastal365 Adult Sick Appointments
- Patient Portal
- Find a Clinician
- New Patient Registration
- Pay Online
- Patient Forms
- Policies and FAQ
- Services and Resources at Coastal
- --
- About Coastal Medical
- Careers
- Contact Coastal