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Forms/Resources

Forms & Resources

Helpful forms for your child’s care

Access the forms you may need before your visit. Please download and complete the appropriate document as instructed by our office.

Patient forms

New Patient Forms

Parent/Legal guardian must complete and bring to the first office visit.

Download Form

 

Privacy

 

Patient Privacy Forms

 

Parent/Legal guardian must complete and bring to the first office visit.

 

Download Form

 

Consent

 

Non-Parental Consent Form

 

Parent/Legal guardian must complete and send this form along with the patient if someone other than the parent will accompany the minor patient to the office visit.

 

Download Form

 

Records

 

Patient Record Request Form

 

Parent/Legal guardian must complete and bring to the first office visit.

 

Download Form

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78 Cambridge Court, Wetumpka, AL 36093
334-567-6915
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