Call 678-0100 to schedule an appointment.
Currently we are not accepting:
1. NEW MEDICARE PATIENTS, UNLESS they have a secondary insurance provider
2. NEW SELF-PAY PATIENTS
Co-payment is expected at check in.
Insurance card and photo identification are required at each visit.

New Patient Forms
New patients can expedite the registration process on their first visit by completing the required information forms in advance. Click on the links below to access and print the new patient forms. If you need assistance, contact the business office at 678-0100.

To use these forms, you must have Acrobat Reader on your computer. Click here to install Acrobat Reader.
 
Forms:
Patient Information Form
Confidentiality Policy
Acknowledgment of Patient Privacy Practices
Patient Responsibility Policy
Notice of Privacy Practices
Southern Regional AHEC Consents

Para utilizar estas formas, usted debe tener Acrobat Reader en su computadora. Chasque aquí para instalar Acrobat Reader

Política de la responsabilidad del paciente
RECIBO DEL AVISO DE LAS PRÁCTICAS DE LA AISLAMIENTO
FORMA ESCRITA DEL RECONOCIMIENTO
Información paciente
AVISO DE LAS PRÁCTICAS DE LA AISLAMIENTO
Autorizaciones de nosotros regionales del Sur