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Patient Form

To ensure we deliver you the best care, Coastal NeuroSurgery will need some personal health information. Feel free to print the form below, fill out relevant fields, and bring a completed copy to your next appointment.

 Patient Information Form

Privacy Disclosure

Coastal Neurosurgery, P.A. is committed to keep all information about you and your care private. With your consent we may use medical information about you to help with and coordinate your treatment with other doctors, nurses, therapists, your insurance carrier or other medical personnel.

 HIPAA Patient Notice of Privacy Practices

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Over 30 years of personalized care restoring quality of life for our patients with complex neurosurgical diseases.
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