At Surf Urgent Care, we know that convenience is important to you. That’s why we make our patient intake, privacy and informational forms available to you prior to your visit.  By completing your forms prior to your visit, you can greatly reduce your wait time in our lobby.

If you have any questions prior to completing your forms, please call us at 252-441-7870.

Patient Privacy and Office Forms
Privacy Practice (PDF Version) 
Notices of Patients Rights and Responsibilites (PDF Version) 
Online Interaction Policy (PDF Version)
Financial Policy (PDF Version)

Registration Form
Patient Registration Form – (PDF Version) 

Medical Records Release Form
Authorization to Release Protected Health Information (PDF Version) 