All new patients should complete the forms and keep the reference document for your files.
Save time before your first visit, by filling out paperwork at home.
When you have completed them, please sign, and bring them to your appointment at Coastal Primary Care.
Please call us if you have any questions about these forms. We look forward to serving you!
Directions:
1. Download the forms to your computer by clicking on the “download the forms”.
2. Print the form and fill it out with a pen.
3. Bring the completed forms with you to your appointment.
If you have trouble with the forms, you may also arrive at our office 15 minutes prior to your appointment and we can provide copies for you to fill out.
Most major insurances accepted: Medicare, Medicaid, Blue Cross Blue Shield,
United Health Care, Humana
Address: 4995 US-1, Fort Pierce, FL 34982
Phone: (772) 465-3225
Hours of operation:
Monday: 7:30 AM – 5:30 PM
Tuesday: 7:30 AM – 5:30 PM
Wednesday: 7:30 AM – 5:30 PM
Thursday: 7:30 AM – 5:30 PM
Friday: 7:30 AM – 5:30 PM
Saturday – Closed
Sunday – Closed