Forms


New Patient Forms

  • Please click on the links below, print out and complete ALL the Registration forms, 5 intake forms, and bring with you to your first appointment.
  • Please also bring with you: Your current insurance card | A photo ID | Any physician referral form (if applicable)

New Patient Registration Forms

Endocrinology Intake Forms Patient Health Record Review of Systems
Advance Directives Ebola Virus Disease Screening


Existing Patient Forms

If this is your first visit in the new calendar year, you have had a change of address or changes to your insurance since your last visit, please complete the packet below and bring it with you to your appointment so that we can update your medical records.

Existing Patient Registration Packet


Associated Brochure Downloads for Your Reference (Not required for office visit)

Patient Rights and Responsibilities
HIPAA Notice of Privacy Practices
Partnership for Safety


Insurance

We accept most major health insurance plans, however it is your responsibility to contact your insurance carrier to verify coverage and benefits. Patients may be held financially responsible for payment of services should the insurance company deny responsibility. Be sure to bring your insurance card with you every time you visit North Georgia Diabetes & Endocrinology. Notify the front desk whenever your insurance coverage changes so that the medical staff can accurately maintain your important medical records.