Patient Forms & Instructions

For the ease and convenience of both potential and current patients, we have made available for download our patient forms and instructions. Simply click on the appropriate link below to begin the download. To view a document, you will need Acrobat® Reader. It is available as a free download here.

If you have any questions, please feel free to contact our office by phone. You can reach us at 706.745.9220, or toll free at 1.877.881.9214.

 

New Patient Registration / Update Patient Information Form

Payment Authorization Form

Medical Information Release Form

Confidential Health Communication Form

Consent for 3D/4D Imaging

Physician for Newborn Form

Glucose Tolerance Test Instructions

Diet Instructions for 3-Hour Glucose Tolerance Test

Essure® Procedure Patient Instructions

Her Option© Procedure Patient Instructions