Reserve Your Spot Now
Enter Patient Information
First Name
*
Last Name
*
Date of Birth
*
Please select the reason for visit:
* Telemed
Annual physical - appointment
Annual physical, walk-in
chest x-ray rule-out TB
Consult
COVID+
DHHS Sports
DHHS Sports - Fball
DMV/DOT Physical
Drug Screen
ER or hospital follow-up
Immigration Physical
Lab work only (visit already completed)
Lung function test/PFT
Medication refill
Pap smear
Pre-employment physical
Pre-op physical
Sick
Sports physical
TB read
TB test
Vaccination
Work Comp
Are you aware that you are utilizing our on-line check-in for the date of service for TODAY (and not a future date)?
Yes
No
Is this your first visit to South Coast Family Medical Center?
Yes
No
Please make sure your phone number is ACCURATE and a CELL phone (not a land line) otherwise you will not receive our texts.
Email Address
Cell Phone Number
*
Text message confirmation will be sent.
Contact Name (if different from patient)
Reserve Spot