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Lovelace Family Medicine, PA

  • Home
  • About Us
    • Care Coordination
    • History
    • Contact
  • Staff
    • Our Providers
    • Office Administrator
    • Support Staff
  • Services
    • Office Care
    • Hospital Care
    • Pregnancy Care
      • Expect More
    • Patient Centered Medical Home
      • CAHPS Survey Summary
  • Patients
    • Current Patients
    • New Patients
    • Fees and Insurance
    • Forms
    • Resources
      • Community Resources
  • Patient Portal
    • Patient Portal Information
  • COVID VACCINE
  • Media
    • Awards

Forms

For your convenience we have included copies of all the forms we use in our office below. Please feel free to print any of them by clicking on the appropriate link. Completed forms may be returned to our office by mail, fax or by dropping them off at the front desk.

Patient Information
Compound Authorization for Release of Information
Notice of Privacy Practices
Acknowledgement of Receipt of Privacy Practices
Records Release Form
Records Request Form
New Patient Past Medical History Form
Authorization to Disclose Health Information
Audio or Video Recording

Contact

Lovelace Family Medicine
PO Box 630
600 N Wheeler Ave
Prosperity, SC 29127
Phone: 803-364-4852
Fax: 803-364-2014

Hours: 8am-5:30pm M-F | Saturday: Please contact the office at 9 am for non-emergent visits only. (Labs and refills are not available during Saturday hours)
Please note the office will open at 9:00 am the 3rd Tuesday of every month.
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Notice of Privacy Practices

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Privacy Policy

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CONTACT

Lovelace Family Medicine
PO Box 630
600 N Wheeler Ave
Prosperity, SC 29127

Phone: 803-364-4852

Fax 803-364-2014

Hours:

M-F: 8am-5:30pm

We open at 9am EVERY Tuesday effective January 3rd 2023

  • NOTICE OF PRIVACY PRACTICES

    Learn More
  • PRIVACY POLICY

    Learn More
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