Please print out and complete ALL forms listed below.
Additionally, please bring your current insurance card and a photo ID to your first appointment.
If this is your first visit in the new calendar year, you have had a change of address or changes to your insurance since your last visit, please complete the packet below and bring it with you to your appointment so that we can update your medical records.
If you would like a copy of your medical records, please complete the form below or fax it to us at 404-365-6501. Please allow two weeks for this request to be completed.
We accept most major health insurance plans, however it is your responsibility to contact your insurance carrier to verify coverage and benefits. Patients may be held financially responsible for payment of services should the insurance company deny responsibility. Be sure to bring your insurance card with you every time you visit Primary Care of Brookhaven. Notify the front desk whenever your insurance coverage changes so that the medical staff can accurately maintain your important medical records.