Patient Information

Patient Forms

Please click on and print the forms below.

Please fill out the forms and bring them with you to your appointment. This will enable us to expedite your check in process. Thank you for your continued support and we look forward to making your healthcare experience a pleasant one.

Insurance & Fees

Our fees are comparable to those charged for similar services in our community. Payment at the time of service is requested to help contain our costs and keep your costs reasonable. Copayments are due at the time of service. For your convenience we do accept both VISA and Master Card.

Please be aware that we must have accurate records of your insurance carrier and policy number. You may wish to speak with our billing department to verify whether or not we participate with your particular insurance plan. We are contracted with most insurance plans.

Please be aware that if your insurance has not paid your charges within sixty days, these charges will become your responsibility. Please let us know of any changes in your insurance as soon as they occur.

In case of emergencies...

If a medical condition arises when our office is closed and you do not feel it can wait until the office reopens, you may reach the on call doctor at (770) 386-1000 at anytime and the answering service will relay your information.

Please inform them of your situation and its urgency otherwise you may expect your call to be returned usually within 30 to 45 minutes.

Patient Medical Records

All information we request from you is needed to provide you with the quality medical services you desire. All the information in your record is confidential and will not be released without your permission.

Copyright © 2015 The Family Medicine Clinic | Designed by Intandemllc