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
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.
Premier Care for Women is a member of a network of physician practices that utilizes MyHealthRecord.com, a secure, web based system that allows you real-time access to your medical record and enables you to contact our office electronically. MyHealthRecord.com is available 24 hours a day for you to review your health records and conduct non-urgent communications with our office.
Using our patient portal, we are proud to offer a convenient way to:
- Request an appointment
- Request prescription refills
- View a summary of your visit
- Request many of your lab/test results
- Review your medical record in a secure environment
MyHealthRecord.com is NOT to be used for urgent or emergency communications. Communication through the portal is not intended to replace an office visit. Please do not send messages through MyHealthRecord.com that require immediate medical attention. If you do not receive a response within 72 hours, you should contact the office.
You may call our office during normal business hours to request that an account be created for you. To visit the login page, click the link below.
- Please allow 2 weeks for results to be posted to the portal after your appointment
- Get your lab results by reading the directions on the portal home page
- Please allow 24 to 48 hours for prescription refills to be completed
Patient portal communication is intended only for the patient that is currently logged in. Any communication relating to another patient including family members needs to be communicated under their own portal ID. You are responsible for the security of your password(s) and for authorizing, monitoring and controlling any access and use of your account and password(s).