Documents & Forms

PCNS currently has 5 forms that need to be completed prior to your new patient visit.  Please answer each question as thoroughly and accurately as possible to save time at your visit.

Each form is a “dynamic PDF” which means you should be able to type directly onto the form from your computer.  You can then either print the forms or save them (as new files) to your computer and email the completed forms to info@portcityspine.com.  You can also print the blank forms and write on them if you prefer.  The sooner we have your completed forms, the shorter your wait time should be at your appointment.  Please make every effort to either email, fax, or drop off your completed paperwork prior to your new patient appointment with our office.  If you cannot provide these completed forms in advance, you will be required to come at least 45 minutes to an hour early to your scheduled appointment.

If you have not been to our office in 3 or more years, please complete all of the new patient paperwork again so that we have updated information for you.  Also, if you have any problems with the attached forms, you may want to check to make sure you are using the most up-to-date version of your PDF reader (such as Adobe).

Established Patients

Please access Patient Portal to update your chart as needed. If your insurance has changed, please send us a secure message through the portal or call us to provide us with that information: 910-338-2773.

Launch Patient Portal

Medical Record Requests 

Your written permission is required for us to request or release your medical records. The request forms are available for your convenience. Please contact our office regarding possible fees for records.

HIPAA

Port City Neurosurgery & Spine strives to maintain the highest standards in healthcare and healthcare compliance. Please click here to read a copy of our HIPAA Privacy Policy.

For more information on the Health Insurance Portability and Accountability Act of 1996 (HIPAA), please click on the following link for the Department of Health and Human Services: http://www.hhs.gov/ocr/hipaa/. You may also call our office and ask to speak to the HIPAA privacy officer: 910-338-2773.