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

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