Patient Registration
We are currently have both physical paperwork and electronic paperwork options, for your convenience.
- Please note that you must contact our office and schedule an appointment before you can access the portal for new patient paperwork.
Supply 2 – (910) 754-7913
Whiteville – (910) 914-0540
Supply 1 – (910) 755-3682
Little River – (843) 663-9090
After you have called to schedule your initial appointment, you will be able to complete your new patient paperwork using the MyMedicalLocker.com link sent to your email or phone, where you can easily fill out forms before your appointment.
If you have any issues completing the paperwork before the time of your appointment, please come in 30 minutes early and you can complete paperwork on our in office ipads. Make sure to bring a list of your current medications as well.
If you would prefer to fill out physical paperwork, you may download or print a copy of the paperwork via the PDF below: