Office Forms

Forms are in Adobe Acrobat format and require the Acrobat Reader. If you don't already have the software, click on the link below.
get adobe acrobat

New Patient Forms
adobe acrobat New Patient Registration Form
If you are a new patient, please complete this form and bring it with you to your first visit. You may also fax it to our office at (770) 474-0566 (but be sure to bring it with your first visit as well).
 
adobe acrobat Notice of Privacy Practices
If you are a new patient, please read and sign the Notice of Privacy Practices. You need to bring only the signed last page with you to your appointment. Click here for more information.
   
adobe acrobat Medical Record Request Form
Use this form to have medical records from your child's previous doctor transferred to our practice. Fill it out and fax or mail it to your previous doctor's office, or bring it by our office and we will fax it for you.
 
Sports Physicals
adobe acrobat Georgia Sports Physical Form
There is a standard form used for clearance for athletic activities in Georgia. It has been adopted by the Georgia High School Association for use in all Georgia schools. You must fill out the history portion prior to your visit and bring it with you to your visit, and we will complete the remainder of the form. Note that this is the new (and longer) form that went into effect June, 2010.

 

Created: 11/1/2004
Last modified: 5/18/2011