Patient Forms

If your are a new patient, please fill out the registration forms below and bring them with you when you come for your appointment.

Registration Forms

• Patient Registration Form
• Patient Consent Form
• Medical Records Release Authorization

Privacy Notices

Download the Notice for the office that you are visiting.

This privacy notice describes how health information about your child may be used and disclosed and how you can get access to this information. Please review it carefully.

• Notice of Privacy Practices - Main Campus
• Notice of Privacy Practices - Bradfordville
• Notice of Privacy Practices - Chattahoochee
• Notice of Privacy Practices - Crawfordville
• Notice of Privacy Practices - Capital Regional Surgical Associates
• Notice of Privacy Practices - Capital Regional OB/GYN Associates
• Notice of Privacy Practices - Southwood
• Aviso Sobre Las Practicas De Privacidad

These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here:

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