Forms at Healthcare South

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We have provided several forms on this web site that you can download, fill out and bring in the office at the time of your appointment. You can either print off our forms and fill them out or fill them with Adobe Acrobat and then print with your signature.


Forms at Healthcare South

Follow My Health Portal

If you are a member of our patient portal, you may also submit a referral request through there. To do so, you may log into your Follow My Health Account, click inbox, then compose, and then select your provider. In the message please state:  

  • The patients name and DOB
  • Patient phone number
  • Specialist provider
  • The date of your appointment with the specialist
  • Reason for appointment
  • Specialist phone and fax number