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PATIENTS

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Forms

For your convenience, we have digital registration forms available to fill out. Don't worry! Your Protected Health Information is completely secure & always remains confidential.

PATIENT FORMS

Let's get started! Click each of the following forms to begin. Have questions? Contact Us.

REGISTRATION

Let's get to know each other! Each patient is required to complete our registration form.

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POLICIES

Learn more about us! Read & understand our Office Policies & Procedures.

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PRIVACY

We take your privacy very seriously. Learn more about how we protect you.

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MEDICAL RECORDS FORMS

Transfering to PAL? Moving & need to release medical records? Use the following forms to authorize PAL to obtain or release medical records

INCOMING

Authorize PAL to obtain confidential medical records from your previous physician.

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OUTGOING

Authorize PAL to release your confidential medical records to your new physician.

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Questions? Contact Us

738 Old Norcross Rd, Suite 100

Lawrenceville, Georgia 30046

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Phone: (770) 277 - 6725

Fax: (770) 277 - 9169

Links
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DISCLAIMER: This website is for personal & private use of individuals only & does not offer or constitute medical advice nor does not create any physician to patient relationship.

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