Patient Resources

In order to make your visit most successful, we ask that you please arrive 20 minutes prior to your first appointment. When you arrive, please bring the following to your appointment:

• Your insurance card and ID
• List of any medications you are currently taking
• A copy of the completed forms above, if you have not already submitted one prior to your appointment.

Prior to your arrival at Onslow Surgical Clinic, we ask that you complete the forms found below- these will be uploaded to a secure email and allow us to expedite your check-in time. Please ensure you check your email after filling these out to approve sending them on to the clinic.

New Patient Form

Having difficulties accessing your new patient forms? Click here.

Your care in our office can heavily rely on records from your previous providers. For your first appointment, we require records of any care you’ve had regarding your diagnosis before your visit. If you have had any imaging, consultations, or emergency room visits outside of Onslow Memorial Hospital concerning why you are coming to see us, you can print a medical release form (ROI) here and drop it by the office for our staff to begin to obtain those records.

Another great option is printing your existing records from your existing patient portal. Examples of possible important items can be found here.

Important Note: This paperwork should only be filled out by patients with existing appointments. When you fill out the paperwork, it will not result in an appointment being scheduled. In order to get scheduled, the offices must receive a referral. Please call our office to discuss your scheduling options prior to completing this paperwork. Thank you!

We ask that you please arrive 15 minutes prior to your appointment time.

To confirm your appointment date and time, please contact (910) 353-7848. Reminder calls and texts are made electronically 48-72 hours in advance. Call our office to enroll in text messaging if you aren't already.

Recovering from recent surgery?

Your post operation period is almost as important to your recovery as the surgery itself. Because Onslow Surgical wants you to have a full and expedient recovery, we have provided some basic information to refer to as needed.

If you have any questions or concerns during your recovery period, do not hesitate to contact us at (910) 353-7848.

If you're paying a bill for Onslow Ambulatory Services, please use this link: https://quickpay.onslow.org/

To make payment arrangements:

You may pay your account balance by Visa, Master Card or Discover. Online payments are available here or you may set up a payment arrangement by calling our Extended Business Office at 1-888-221-3586 Monday through Friday from 8:00 a.m. to 5:00 p.m.

Payments can be made at 200 Memorial Drive, Jacksonville, NC 28546.

All insurance co-payments and deductibles are due at the time of service.

If you have any questions, please reach out to our Patient Financial Services Customer Service by calling at910-577-4703 or at 1-888-221-3586 or visiting the office at 200 Memorial Drive, Jacksonville, NC 28546.

We are committed to providing you with high quality patient care and services to include our billing process and our Patient Payment Plan options. Our Patient Financial Service representatives are available to assist you from 8:00 am to 5:00 pm Monday through Friday. We are closed for holidays.

Always check with your insurance company before selecting a physician.

We accept the following insurance plans: most private insurance (e.g. Blue Cross Blue Shield, United Health Care, Medcost) Medicare and Medicaid.

The purpose of this document is to let you know about your protections from unexpected medical bills. You may also be given the option of whether you would like to give up those protections and pay more for out-of-network care.

Surprise Billing Notice (English)

Surprise Billing Notice (Spanish)

In order to serve our patients in a timely manner we adhere strictly to our schedule. If you are fifteen minutes late for your appointment, we may ask you to reschedule to another date and time. Please inform our office if you are running behind so we can adjust our schedule accordingly or reschedule as appropriate.

If an appointment must be cancelled or rescheduled, please notify us at least 24 hours in advance. Cancellations made less than 24 hours prior to the scheduled appointment time, as well as no shows, will be charged a fee of $25.00. Informing us of your cancellation simply allows us to see other patients that may need to be worked in and opens up other scheduling options for patients.

If a patient fails to notify the office 24 hours ahead of the scheduled appointment and does not attend the appointment, this is considered a ‘No Show’. No show appointments may be charged a fee of $25.00, non-billable to insurance. No show appointments are to be rescheduled at the discretion of the provider. New patients that fail to notify the office and No Show their first appointments may not be rescheduled in the office.

Please refer to our Appointment No Shows Policy document for more information.

If you have any special needs or requirements, please make sure that you bring these to the attention of our staff before your scheduled appointment time. Courtesy wheelchairs are available for your use.

It is the policy of our office to return all calls within 72 business hours, should you phone and get a voicemail please leave a detailed message to include the patient's name and date of birth (DOB), as well as pharmacy if the request is for medication refills.

Please allow up to 48 hours for prescription refill requests to process. You may request a refill by calling our office or your pharmacy.

Please refer to our Photography/Recording Patient or Staff Policy for information.

Please do your best to silence your cell phones upon entering our practice to better serve you and our patients.

A patient has the right to file a grievance through the Patient Advocacy Department by phone 910-577-2345 or email at Desiree.Evans@onslow.org when they have concerns following an in-office visit.

In our effort to provide highly successful and anxiety-free care, Onslow Surgical Clinic tries to provide as much information to our patients and their families as possible. Below are some resources for better understandings of medical conditions, procedures and other information. If you have specific questions, please be sure to ask your physician or our surgeons.

National Cancer Institute — Cancer Information Service
Susan G. Komen Breast Cancer Foundation
Healthfinder — A service of the U.S. Dept. of Health & Human Services
University Health Systems of Eastern North Carolina — (Pitt Memorial Hospital)
American College of Colon and Rectal Surgeons — Click on the subject to see more information:

• Anal Cancer
• Anal Fissure
• Anal Warts
• Bowel Incontinence
• Colonoscopy
• Colorectal Cancer
• Colorectal Cancer Surgery – Follow-up Evaluation
• Constipation
• Crohn’s Disease
• Diverticular Disease
• Hemorrhoids
• Irritable Bowel Syndrome
• Ostomy
• Pilonidal Disease
• Polyps of the Colon & Rectum
• Pruritus Ani
• Rectal Prolapse
• Rectocele
• Ulcerative Colitis