Forms Overview
If you are unsure which forms are right for you, please call our office at 770-487-0808.
New Patient Forms
Once you have called our staff and set up an appointment to see Dr. Anders, please download, complete, and bring these forms to your appointment.
Wellness Forms
If you have confirmed with our staff that your visit is regarded as a 'Wellness Visit,' please download, complete, and bring these forms to your appointment.
Welcome to Medicare
If you are in your first 12 months of Medicare and have consulted our staff, please download, complete, and bring these forms to your appointment. More information about the WTM visit is available here.
Medicare Annual Wellness Physical
If our staff has specified your visit as an Annual Wellness Visit (AWV), please complete these forms prior to your appointment. More info about the AWV physical is available here.
NOTICE OF PRIVACY PRACTICES
Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.
AUTHORIZATION AND CONSENT FOR TREATMENT
All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
Financial Policy
This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.
AUTHORIZATION FOR RELEASE OF PMI
Allows patients to authorize the disclosure of their private medical information (PMI) to a designated individual, company, agency, or facility.
Preferred Contacts
Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.
Language Services
This link assists patients with receiving care in a language other than English.