Patient Forms & Patient Portal
For your convenience, the Health History Forms can also be downloaded here and completed manually. To help facilitate your wait time you may FAX these forms to 404-601-0026 prior to your appointment day.
Annual Exam Appointments
In addition to your Health History Forms, please print out and complete the Patient Registration Forms below.
- Patient Registration Forms (Registration + Financial Policy + Medical Practice Annual Acknowledgement)
Please DO NOT FORGET to bring the following to your appointment as well:
- Your current insurance card
- A photo ID
- Any physician referral form (if applicable)
- Your medications list
- $6 for parking
Associated Brochure Downloads for Your Reference
- Patient Rights and Responsibilities (Spanish)
- HIPAA Notice of Privacy Practices (Spanish)
- Partnership for Safety (Spanish)
Please use this form to request medical records. Be sure to sign, and date this form and provide a complete fax number or address where records need to be sent.
Fax this form to 404-851-9894.
Please allow 5-7 business days for processing.