Surfside Beach, South Carolina · By appointment Call 843-477-1602

Patient Resources

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Forms and information from Coastal Medical Clinic, gathered in one place — the patient forms to complete for your care, the clinic's information flyers on menopause and andropause, and documents about the metabolic testing used at the clinic.

Patient forms

Coastal Medical Clinic's patient forms are available below as PDFs. The Welcome letter introduces new patients to the clinic; the remaining forms cover your personal health history, release of your medical records, individual authorization, and follow-up appointment information.

Welcome

The clinic's welcome letter for new patients.

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Personal Health History

Records your personal health and history information for your care.

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Medical Release

Authorizes the release of your medical records.

Download PDF →

Individual Authorization

The individual authorization form used by the clinic.

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Follow-Up Appointment

Information for your follow-up appointments.

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Information flyers

The clinic's flyers on hormone changes in women and men:

Women and Menopause

The clinic's flyer on women and menopause.

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Men and Andropause

The clinic's flyer on men and andropause.

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Menopause and Andropause

A combined flyer covering menopause and andropause.

Download PDF →

Metabolic testing information

Coastal Medical Clinic's programs draw on metabolic testing, including resting metabolic rate measurement. Two reference documents are available below: a guide to the BodyGem handheld metabolic measurement device, and the published validation material for the MedGem device.

BodyGem — Handheld Metabolic Measurement

Guide to the BodyGem device used to measure resting metabolic rate.

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MedGem — Validation

Validation documentation for the MedGem metabolic measurement device.

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ARK — Patient Guide

The clinic's patient guide from Ortho Molecular Products.

Download PDF →

Ready to discuss what's next?

Request a consultation with Dr. Smolenski to discuss your concerns, your evaluation, and the appropriate next steps for your care.

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