Patient Information

Welcome to Chapin Pediatrics!

We consider it an honor and privilege to be chosen to serve as the healthcare provider for your child. If you are a new patient that has received confirmation from us to join our family you will find the forms below helpful. Filling out the forms prior to your first visit and bringing them with you will assist in the new patient processing.

If you have any questions about these forms or anything in general, please do not hesitate to contact our office. If you are on social media sites, please make it a point to follow us/like us as we attempt to use all means possible to communicate and keep you informed.

Again, we thank you for the privilege to serve you.

The following forms must be completed and returned before your child’s appointment:

Insurance and Billing

We are not a party to the contract held between you and your insurance company. Therefore, the responsibility of bill payment falls on the parent or guardian of our patients. A service charge of $35 will be added for any checks drawn on insufficient funds. For your convenience we accept cash, check, credit cards or debit cards. The parent/guardian seeking medical treatment for the child is responsible for submitting payment after care is rendered.

Please contact your insurance company regarding co-payment, co-insurance, deductible, and out-of-pocket amounts.

Adding Insurance

If you are pregnant or have a newborn we know that insurance isn’t always at the forefront of your mind. Be sure to call your insurance provider within 30 days of delivery to ensure that your child is added to your insurance policy.

To add your child to your insurance policy, call the phone number located on your insurance card. Insurance companies require that your newborn be added to your policy in order to process medical claims. A delay in updating your policy could result in denied claims which then become your responsibility to pay. If your insurance is through an employer, you may need to inform both the insurance company and your employer.

We are here to help.


For questions about insurance claims and billing, you can reach our Billing Department at (803) 932-2200 option 3 available Monday-Friday 8-5. They can also be contacted by email at

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723 Chapin Road
Chapin, SC 29036


803.932.2200 Phone
803.932.2225 Fax


Monday through Friday, 8:00am-5:00pm.
We do not close for lunch.

Saturday hours are 8:00am-12pm.
We share call with Ballentine Pediatrics and we post weekly who is on call.

NCQA Recognized Practice