New patients must complete the forms listed below for the first appointment. These forms can be “fillable” (downloaded, saved, filled out on a computer and returned) or “printable” (downloaded, printed out, filled in by hand and returned).
“Printable” Form Instructions — print out and complete by hand.
1. Download the form file PDF and print it out.
2. Fill in the blanks by hand — please print clearly.
3. Mail or bring to the office; fax the completed form to 770.475.9244; or scan and attach to an email sent to firstname.lastname@example.org.
“Fillable” Form Instructions — fill out on computer.
1. Download the form file PDF and “Save Page As…” a new PDF with a file name that includes your name (e.g., “YourName_gh_new_pat_reg_form_090715a.pdf”).
2. Close the new file and then reopen it with Adobe Acrobat Reader (downloadable for free from Adobe.com if needed).
3. Type the information into the form, save (or “save as”), close and then reopen it to make sure the entered information is still there.
4. To return the filled form, either:
Patient Information Form
New Patient Routine Procedures Form
New Patient Privacy Practices Notice
Read this HIPAA info, keep a copy for yourself and return a copy signed (on page 3):
Receipt of Written Privacy Practice