Forms & Policies

To help protect every child in our care, we strongly recommend that patients receive all recommended vaccinations before their second birthday. Families of children who are immunocompromised will meet with one of our physicians to determine the safest approach based on their child’s individual needs.

If a parent or guardian declines any CDC-recommended vaccine, they must sign a vaccination declination form. Refusal to sign the form may result in dismissal from the practice.

SouthernMED Pediatrics reports all administered immunizations to the South Carolina Immunization Registry. Information about Immunization Registry Regulation 61-120 is available in South Carolina Code Section 44-29-40(B).

This summary is provided for convenience. Please review the complete policy document for full details. The policy document is the official and most current version of our practice policies.

We value your time and work hard to keep appointments running as scheduled. Because timely arrivals help us provide efficient care for every family, we ask patients to check in on time. Appointment reminders are sent using the contact information on file, and upcoming visits can also be viewed through the Healow app or Patient Portal. We understand that unexpected delays happen, so we provide a 15-minute grace period for check-in.

Arrivals after the 15-minute grace period will be recorded as a no-show. If a sick or injury appointment is missed, we will make every effort to offer another appointment that day. However, we cannot guarantee a specific time or the same provider. Missed well visits must be rescheduled for another date and time.

Missed appointments come at a cost to us and to other patients who could have been seen in the time set aside for you. Patients with more than two no-shows within a 12-month period may be dismissed from the practice. If dismissal occurs, we will continue providing care for up to 30 days from the date of the dismissal letter, allowing time to establish care with another provider.

Appointments canceled or rescheduled before the scheduled date and time will not be considered no-shows. Whenever possible, we appreciate at least 24 hours’ notice.

This summary is provided for convenience. Please review the complete policy document for full details. The policy document is the official and most current version of our practice policies.

A completed Medical Records Release form is required to receive a copy of your child’s medical records. Please allow up to 30 days for processing. A fee may apply for this service.

Biological parents have equal rights to access their child’s medical records. In cases of divorce or separation, SouthernMED Pediatrics cannot restrict either parent’s access unless we receive court documents that specifically require it.

SouthernMED Pediatrics may also search patient medical records to identify individuals who may qualify for clinical trial recruitment.

This summary is provided for convenience. Please review the complete policy document for full details. The policy document is the official and most current version of our practice policies.

SouthernMED Pediatrics is committed to providing high-quality care for your child while following all applicable federal and state laws regarding parental rights. A parent may be denied access to a minor child’s medical records or office visits only when we have a confirmed court order on file that specifically limits that access. Without such an order, either parent or legal guardian may sign forms, request records, attend appointments, and consent to treatment. Our team cannot become involved in disputes regarding individuals named on consent forms unless directed by the court.

Parents are responsible for discussing and making decisions about appointments, treatment, and vaccinations before visiting our practice. They must also communicate with one another about their child’s care, appointments, and other relevant information. SouthernMED Pediatrics does not communicate separately with each custodial parent or notify one parent about appointments scheduled by the other.

Payment is due at the time of service from the parent, guardian, or caregiver who accompanies the child. Any financial arrangements must be made before the appointment.

Our providers do not provide statements expressing personal opinions, affidavits for court proceedings at a parent’s request, or IRS letters verifying custody, names, or related matters.

If these guidelines are not followed or family disputes interfere with our ability to care for your child, SouthernMED Pediatrics reserves the right to dismiss the family from the practice.

This summary is provided for convenience. Please review the complete policy document for full details. The policy document is the official and most current version of our practice policies.

Under South Carolina law, minors age 16 or older may consent to healthcare services for themselves without permission from a parent or another individual. Beginning at age 16, patients may also complete their own HIPAA authorization form and decide who may or may not access their protected health information. We encourage parents to discuss these rights with their teens.

At age 18, patients are legally considered adults and must complete and sign all required patient paperwork. Any disclosure of their protected health information will be made at their discretion.

This summary is provided for convenience. Please review the complete policy document for full details. The policy document is the official and most current version of our practice policies.