Forms

To expedite your visit , please download and print the new patient forms:

New Patient Medical Forms

• New Patient Registration Form:
• New Patient History Form:
• HIPPA Informed Consent Form:
• Authorization for Treatment Form
• Payment Policy Form

Sport Physical Form High School

Sport Physical Form Middle School

Clayton State University New Patient Forms Only

• New Patient Quick Registration Form:
• HIPPA Informed Consent Form:
• Authorization for Treatment Form
• Payment Policy Form

Well Child Visit Forms

• Well Child History and Physical
• Well Child Screening Form
• Well Child Screening Form updated
• Developmental Screening Tool English
• Developmental Screening Tool Spanish
• Screening tool for Autism in English

Frequently Asked Questions

Payment is expected at time of service. Please bring your picture ID and Insurance card.