Secure Online Forms - NEW! Save time at check-in! Complete online and submit to our front office!
- Patient Registration Information
- required for all new patients
- Policies and Procedures - required for all new patients; existing patients may be asked to update this form at check-in
- Receipt of Notice of Privacy Practices, and Authorization to Share Protected Health Information - required for all new patients; existing patients may be asked to update this form at check-in
- Under 18 Guarantor Form - required for all patients under the age of 18. Patients under the age of 18 MUST be accompanied by a parent or legal guardian to their appointment. Minors who arrive without a parent or legal guardian will be asked to reschedule.
- Privacy Policy: (for your reference) describes how medical information about you may be used and disclosed, and how you can obtain access to this information
- Patient Health History Form: (PRINT ONLY) we ask that our patients provide a complete and up-to-date medical history at each visit - please print this and bring it with you to your appointment OR plan to complete one at check-in. Secure online form not available at this time.
If you prefer to print & complete paper forms:
New Patients - Printable PDFs
-
New Patient Packet (5 pages): please print, complete, and bring to your appointment
- Privacy Policy: (for your reference) describes how medical information about you may be used and disclosed, and how you can obtain access to this information
- Under 18 Guarantor Form: patients under the age of 18 are required to have a guarantor on file.
Returning Patients - Printable PDFs
Please note that you may be asked to update any of the below forms at check-in, even if you are a returning patient. Thank you!
- Patient Registration Information: for new patients OR existing patients who wish to update information
- Policies and Procedures: information on our medical, financial, billing, and other policies
- Receipt of Notice of Privacy Practices, and Authorization to Share Protected Health Information: change or update the party/parties with whom we may share your protected health information (PHI) Note: This form is NOT for releasing medical records to yourself or another office - please see the links below.
- Privacy Policy: describes how medical information about you may be used and disclosed, and how you can obtain access to this information
- Patient Health History Form: we ask that our patients provide a complete and up-to-date medical history at each visit
- Under 18 Guarantor Form: patients under the age of 18 are required to have a guarantor on file.
Medical Records Release
Note: Please allow up to 7 business days for medical records requests to be completed. Records sent from our office will be sent via mail or fax. If you are requesting records to be faxed, you must provide a valid fax number for the receiving office. Records longer than 25 pages will be mailed.
- To release records to Georgia Skin Specialists from a different office: Use this form if you would like to have records sent TO Georgia Skin Specialists from your previous provider's office
- To release records from Georgia Skin Specialists to a different office: Use this form if you would like to have Georgia Skin Specialists send your records to another office
Frequently Asked Questions
Click here to see answers to common questions.