Patient forms, ready to complete before your visit

Why we ask for these forms

Every clinical visit at Synergy Spine Center begins with a shared understanding of your medical background, insurance coverage, and administrative preferences. The forms below capture the information Dr. McMillan and the office team need to provide safe, informed care — and to ensure the practice's obligations under federal law (HIPAA, patient consent, insurance verification) are met before your visit begins. Completing them in advance shortens the time you spend in the waiting room and lets the consultation focus on what matters clinically: your symptoms, your imaging, and your options.

The forms are provided as PDF downloads. You can complete them by hand or use a PDF editor to fill them electronically. Completed forms can be brought to your visit, uploaded through the free MRI review portal along with your imaging, or emailed to the office in advance. See the submission instructions below for the specific pathway that fits your situation.

Download the forms

Click any card below to download the corresponding PDF. All eight forms are typically needed for new patients; existing patients returning for follow-up may only need updates to the demographics and medical history forms.

What each form is for

Here's a brief description of what each form captures and why we ask for it — patients sometimes want context before filling out anything, particularly for the more detailed medical and financial forms.

• Welcome Letter — the practice's introduction to new patients. Explains what to expect at your first visit, the intake process, and how our care model differs from a traditional spine surgery practice. Read this first.
• Patient Demographics — basic contact information, insurance details, emergency contact, and primary care physician. This is the standard intake form every medical practice uses; it takes about five minutes to complete.
• Financial Policy — how the practice handles insurance billing, transparent self-pay pricing (see transparent pricing), deposits, and payment expectations. Signing acknowledges you understand the practice's payment policies before care begins.
• Medical Records Release — HIPAA-compliant authorization for the practice to obtain records from your prior providers or to release records to a designated recipient. Only needed if we need to request or release records on your behalf.
• Directions — written directions to the Seneca office from major regional highways, plus a printable map for patients who prefer offline navigation. Also see our Seneca, SC office for interactive directions and drive-time estimates.
• Medical History — comprehensive medical history including current medications, allergies, prior surgeries, and relevant family history. This is the clinical foundation for your consultation; the more complete this is, the more productive the conversation with Dr. McMillan will be.
• Office Policies — scheduling, cancellation, prescription refill, communication, and after-hours policies. These clarify what to expect from the office in day-to-day interactions.
• HIPAA Notice — the federally required Notice of Privacy Practices detailing how the practice uses and protects your Protected Health Information (PHI). More detail on the federal HIPAA framework is at HHS.gov — HIPAA.

How to submit completed forms

There are three practical ways to get your completed forms to the office. Each works — pick whichever fits your situation.

• Bring them to your visit. Print, complete, and bring the forms with you on the day of your visit. This is the simplest path for local patients.
• Upload them with your imaging. If you're submitting imaging through the free MRI review portal, you can upload completed forms alongside your DICOM files. The portal is HIPAA-compliant and encrypted in transit.
• Mail or email them ahead of time. Mail completed forms to Synergy Spine Center, 457-E Bypass 123, Seneca, SC 29678. Email is acceptable for non-clinical forms (welcome letter acknowledgment, financial policy) but medical history and demographics should use one of the more secure paths above.

Privacy, HIPAA, and how we handle your information

The practice operates under the federal HIPAA Privacy and Security Rules for all Protected Health Information (PHI). What that means practically: the information you provide on these forms is used only for your clinical care, billing, and operational functions of the practice — not shared with third parties for marketing, not used for research without your explicit written authorization, and not disclosed to family members or other individuals without your consent. The HIPAA Notice PDF above covers the details required by federal law, including your specific patient rights and how to file a complaint if you believe your privacy has been violated.

Forms submitted electronically are handled on HIPAA-compliant infrastructure with encryption in transit. Paper forms are stored in secured office locations with access restricted to authorized personnel. The practice's data retention follows federal and state regulations. For patients who prefer paper-only communication, the practice can accommodate that preference — mention it during scheduling.

Common questions before your first visit

Below are the questions we hear most often from new patients about the intake process. If your question isn't answered here, call the office at (864) 886-9888 before your visit and the office team can address it directly.

What happens after you submit

Once forms are received, the office team enters the information into the practice's HIPAA-compliant electronic medical record and reviews it before your visit. Dr. McMillan reviews your medical history alongside your imaging in preparation for the consultation. If the office team identifies any gaps or clarifying questions, they'll reach out by phone before your visit rather than waiting to address them during the appointment. Broader context on the patient pathway from initial contact through procedure is at how the process works. For out-of-town patients, the specific visit structure is at the 3-day plan and the out-of-town patient guide.