Patient Forms

Download any of the files that you need. Use the form below to securely send them to our office.

New Patient Packet
New Patient Packet.pdf
Adobe Acrobat document [298.0 KB]
Notice of Privacy Practices
This document explains your rights and our responsibilities regarding your health information.
Notice of Privacy Practices.pdf
Adobe Acrobat document [358.7 KB]
Request Your Medical Records
Fill out this form if you would like a copy of your health information.
Medical Record Request.pdf
Adobe Acrobat document [320.4 KB]
Interpretation Services
Click here to learn about our interpretation services
Adobe Acrobat document [6.9 MB]

Contact Us

Phone:  706 854-2160 706 854-2160

Fax:  706 854-2930



465 North Belair Road

Professional Building 3, Suite 1C

Evans, GA 30809

Office Hours

Monday: 8:00 AM to 5:00 PM

Tuesday: 8:00 AM to 5:00 PM

Wednesday: 8:00 AM to 5:00 PM

Thursday: 8:00 AM to 5:00 PM

Friday: 8:00 AM to 5:00 PM

Saturday: 8:00 AM to 10:00 AM