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MICKEY FAMILY PRACTICE, P.A. 1025 West Meeting Street, Suite 200 Lancaster, South Carolina 29720 Phone 8032857414Toll Free 18778376507Fax 8032834329**Authorization To Disclose Health Information &

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1. To fill out Mackey Family Practice Offices & form, follow these steps:
2. Start by entering your personal details, such as your full name, date of birth, and contact information.
3. Next, provide your medical history, including any existing conditions, allergies, or previous surgeries.
4. If you are currently taking any medications, list them in the designated section along with the dosage and frequency.
5. Specify whether you have any preferred pharmacy or primary care physician.
6. If you have insurance coverage, provide the necessary details, including your policy number and insurance company.
7. Review the form for completeness and accuracy before submitting it.
8. Sign and date the form to confirm its authenticity.
9. Submit the filled-out form to Mackey Family Practice Offices either in person or through their online portal.

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1. Anyone seeking medical care from Mackey Family Practice can benefit from their offices.
2. Patients of all ages, from children to adults, can utilize their services.
3. Individuals who require routine check-ups, vaccinations, or treatment for common illnesses can visit Mackey Family Practice Offices.
4. People in need of management for chronic conditions, such as diabetes, hypertension, or asthma, can also benefit from their specialized care.
5. Those looking for a trusted primary care physician or a healthcare provider for ongoing medical care can turn to Mackey Family Practice Offices.

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