New Patient Packet
If this is your first visit to our office, complete our new patient information packet before your first visit.
- Patient Registration
- Patient Health History
- Medical Records Release
- Medical Records Release - en Español
- Authorization for Medical Care Form
- Notice of Privacy Practices
- Acknowledgement of Receipt of Notice
Strong 4 Life Healthy Habits Assessment Forms
- Healthy Habits Assessment for Children
- Healthy Habits Assessment for Teens
- Valoriacion de Habitos Saludables para Niños
- Valoriacion de Habitos Saludables para Adolescentes
Attention Deficit Disorder Assessment Forms
Please note that if you do not receive a 3231 Form or Visual & Hearing Form at the time of your child’s check-up, there will be a $10 charge for each form.
Other forms required by schools, offices, daycare or other organizations will require a fee.
Forms requiring ONLY a physician's signature, no charge.
Work form for parents - $10.00
Disability forms - $10.00
Letters required by the following: - $10.00
Daycare application forms - $10.00
Camp, sports or college forms - $10.00
Transfer of records - flat fee per chart - $15.00
*Parents may request a copy of GA Law 31-33-3 to clarify this policy.