Patient Forms


For New Patients


We need a detailed medical and family history for your child to help us identify the individual needs he or she may have.

All new patients must have the following three forms completed so that we may include them in the child's chart.
Please download and complete the New Patient Registration Forms listed below and bring them to your child's first visit  

1. Office Policies and Consent Forms
2. Initial History Questionnaire

3. Demographic Form

Don't forget your child's immunization history!

You may fax the forms in advance to 404-297-8753, ATTENTION:  New Patient Information.

For your convenience we have also included here a copy of our H.I.P.A.A. compliant  Notice of Privacy Practices

 

What to Expect

Upon arrival, you will be asked for the completed forms (unless you faxed the forms in advance) AND the following items:

  • If your Health Plan requires a Co-payment, it will be collected when you check in.
  • Photo ID of Parent or Guardian
  • Health Plan Insurance ID Card (MUST BE CURRENT) for each active policy for the patient
  • Previous medical records if applicable

In case you need to obtain records from your child's previous provider, use the links below to print the appropriate Medical Records Request Form.

School Form Policy and Form Requests

ADHD treatment forms: 

Additional forms:


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*These forms require Adobe Acrobat Reader. Click to download.