Patient Forms

New Patient Registration Forms

A first-time visit to a physician’s practice can involve a daunting amount of paperwork prior to your meeting with the doctor. We have provided most of the required first-visit paperwork for you to print and complete at your convenience at home prior to your visit. Our patients have found this to be less stressful and it gives them more time for thoughtful, accurate completion. You may call if you have questions, or we will assist you when you arrive.

The information you share in the forms helps to make the most of your time with the physician.

Before you start filling out the new patient registration forms, download and read our welcome letter.  Then please print the following forms, complete all pages, and bring them to your first appointment:

• Patient Information Form
• Medical & Ocular History Questionnaire
• Family Medical History Questionnaire
• Patient Contact Information Sheet
• Acknowledgment of Receipt of Notice of Privacy Practices

In addition to the above forms, please bring your insurance cards, driver’s license or photo ID, and any applicable co-pays or deductibles.

Privacy Policies & Guidelines

• Notice of Privacy Practices
• FMLA & Short-Term Disability Guidelines

Driving Directions

• Birmingham Office
• Grandview Office
• Oxford Office
• Jasper Office
• Pell City Office
• Sylacauga Office