Insurance & Forms

Complete the forms below and bring them with you to your appointment. Please also arrange to have all medical records sent to our office and bring the following:



Payments may be made by cash, check or credit card. Payment is expected at the time of service unless you have made other arrangements. If you are experiencing a financial hardship, you may qualify for coverage under the Roper St. Francis Healthcare Financial Assistance Program. Please ask our staff for more information or contact the Billing Office at (843) 789-1620. We ask that you check with your insurance carrier prior to your visit to ensure scheduled services are covered benefits.

We value you as our patient and thank you for choosing Cane Bay Primary Care.

Patient Forms