New Patient Forms

Print & Complete Your Forms

Patient Pre-Registration Packet (includes the following forms):

  • Overview Form
  • History & Physical Form
  • Current Medical History Form
  • Patient Demographics & Insurance Form
  • Authority for Release of Health Information Records

Download Patient Pre-Registration Packet

Return Your Forms

If it’s at least two days prior to your appointment: You may fax or e-mail your forms (with cover page) to us. If at all possible, please also scan a legible copy of your insurance card(s) and driver’s license, along with your registration forms. Please, no photos; scans only).

Fax: (205) 484-2671


If it’s less than 24 hours before your appointment: To prevent any delay before your visit, please bring registration paperwork with you to your first visit instead of e-mailing or faxing it. Our office needs 24 hours to process registrations that are emailed or faxed.

Note: Some of our physicians may have additional paperwork to be completed at your visit. Please arrive 20 minutes prior to your scheduled appointment in order to complete any additional paperwork before seeing your physician.