General Patient Forms & Information

MCMC Non-Urgent Contact Request Forms

New Patients

Mid Coast Medical System accepts new patients. To decrease your wait time, we ask that you please fill out the online pre-registration forms below for both a hospital stay and a clinic visit. Both forms can be found here:
You can also print the New Patient Packet and return the completed forms to the clinic prior to your appointment, if possible. You can also fax the forms to 979-543-4137. Download printable forms below.

Additional Forms and Procedures

El Campo Memorial Hospital (ECMH) and its predecessor have been providing the highest quality medical care in El Campo for over 68 years, and at the current location since 1979.The hospital is accredited by state and federal regulations (Medicare/Medicaid). Patient Billing: Various physicians involved in your care at ECMH will bill you directly for their services. These may include your anesthesiologist, emergency room physician(s), radiologist, pathologist, cardiologist or other consulting physician during your ER visit or hospital stay. Please remember that some physicians are private practitioners (contracted by ECMH and not an actual employee of ECMH) and may not be a provider on your specific managed care plan.