These forms may be downloaded
Document |
Description |
Type & Size |
|
CHIROPRACTIC HEALTH HISTORY FORM.pdf
|
NEW PATIENT HEALTH HISTORY FORM
|
pdf
0.19 MB
|
|
CARDIOVASCULAR CLEARANCE FORM.docx
|
DOT CLEARANCE FORM FOR CARDIOVASCULAR CONDITIONS
|
docx
0.10 MB
|
|
COUMADIN THERAPY CLEARANCE FORM.docx
|
DOT CLEARANCE FORM FOR COUMADIN THERAPY
|
docx
0.08 MB
|
|
DIABETES CLEARANCE FORM.docx
|
DOT CLEARANCE FORM FOR DIABETES
|
docx
0.09 MB
|
|
EPILEPSY CLEARANCE FORM.docx
|
DOT CLEARANCE FORM FOR EPILEPSY
|
docx
0.08 MB
|
|
HYPERTENSION CLEARANCE FORM.docx
|
DOT CLEARANCE FORM FOR HYPERTENSION (HIGH BLOOD PRESSURE)
|
docx
0.09 MB
|
|
MEDICATIONS CLEARANCE FORM.docx
|
DOT CLEARANCE FORM FOR MEDICATIONS THAT MAY CAUSE DROWSINESS OR IMPAIR YOUR ABILITY TO DRIVE
|
docx
0.10 MB
|
|
DOT REQUIREMENTS CHECKLIST.docx
|
FEDERAL DOT CMV MEDICAL EXAMINATION CHECK LIST
|
docx
0.09 MB
|
|
SLEEP APNEA CLEARANCE FORM.docx
|
DOT CLEARANCE FORM FOR RESPIRATORY DISFUNCTION/SLEEP APNEA
|
docx
0.09 MB
|
|
VISION CLEARANCE FORM.docx
|
DOT CLEARANCE FORM FOR VISION ASSESSMENT
|
docx
0.08 MB
|
|
CLEARANCE PRESCRIPTION MEDICATION LIST.docx
|
PRESCRIPTION MEDICATION LIST THAT MAY CAUSE DROWSINESS OR IMPAIR YOUR ABILITY TO DRIVE
|
docx
0.03 MB
|
QuickFacts
Address
Hemingway Spinal Care Center
304 E BROAD ST,
P O BOX 1601
HEMINGWAY,
SC
29554
|
Hours
|
Monday: | 8 AM - 1 PM, 2:30 PM - 5 PM | Tuesday: | Closed | Wednesday: | Closed | Thursday: | 8 AM - 1 PM, 2:30 PM - 5 PM | Friday: | Closed | Saturday: | Closed | Sunday: | Closed |
|
Contact
Phone: 843-558-0056
Fax: 843-558-0056
|