Patient FORMS

For your convenience here are the forms that may be helpful during your journey here at Charleston Oncology.

Records Request Form for Records to Charleston Oncology.

Medical Release For Date of Service 11/6/2022 to Present.

Medical Release For Date of Service before 11/6/2022.

New Patients

Before your first visit to Charleston Oncology, please download the packet, complete it and bring it with you to your first appointment. In addition, please bring a photo ID along with any insurance ID cards/documentation. If you have obtained any medical records, please bring those along with you to your appointment.

about hospital outpatient departments

Thank you for choosing Bon Secours St. Francis Hospital, part of the Roper St. Francis Healthcare health system, for your care. Please note that beginning November 6, 2022, your patient billing statement may look different. Your bill will come from Roper St. Francis Healthcare. This bill may include charges for the physician or provider caring for you as well as separate charges for the services delivered within the facility. Here are some details about hospital outpatient departments and the facility charges.

Patient

Portal

Patients can use the portal for appointment requests, bill pay, lab results, and many other features.

Portal

Pay Bill Now

Send UsA Message

Please use this form for new patient appointment requests only. All other clinical needs and correspondence for existing clients should use the patient portal by clicking HERE.

LOCATION*

PROVIDER*

FIRST NAME*

LAST NAME*

EMAIL ADDRESS*

PHONE*

Birthdate*

MESSAGE

I understand and agree that any information submitted will be forwarded to our office by email and not via a secure messaging system. This form should not be used to transmit private health information, and we disclaim all warranties with respect to the privacy and confidentiality of any information submitted through this form.*

If you are experiencing symptoms that may be associated with oncology or hematology disorders, we will schedule your appointment consultation immediately with a physician referral from your primary care, OBGYN, urgent care, or other established physician.

Proactive Health: Prostate and Blood Cancer Awareness

Sep 15, 2025

Proactive Health: Prostate and Blood Cancer AwarenessTaking charge of your health means being informed and proactive, especially when it comes to cancer prevention and early detection. This September, as we observe both Prostate Cancer Awareness Month and Blood Cancer...