Office Hours:
Mon - Thurs: 8:00am - 5:00pm
Fridays: 8:00am - 2:00pm
Extended Hours:
Mon & Wed: 5:00pm-6.30pm
2713 Charles Hardy Pkwy, Ste. 223
Dallas, GA 30157

Phone: (678) 324-7021
Fax: (678) 401-3016

For All Patients

Patient Forms

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, and our staff will assist you with your questions on the day of your visit.

Please printout and complete the following forms:


Note: The above documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here.

For New Patients

We are excited you have chosen us to be your health care provider. Here a few tips to make your first visit seamless.

  • Please plan to arrive 15 minutes before your appointment time to complete the registrations process.
  • Please bring with you all your curent medications in their original bottles and any prior medical records you may have available.
  • Unless scheduled for blood or other tests, you may eat and take all your medications as usual.
  • Please bring with you your Insurance card, Drivers Licence or other form of picture ID.

For Established Patients

We are happy to maintain your trust in us.

  • As usual, please arrive 15 minutes before the appointment time.
  • If scheduled for an annual examination, please present after an 8 hour fast. We will generally schedule all such appointments within the early slots of the day.
  • If you have been hospitalized in the interim, please remember to bring with you any discharge instructions and medication changes.
  • If you are hospitalized, please let the office know or have the treating provider notify us.

Billing & Insurance

We participate in Medicare / Medicaid Programs and accept most major insurance. Please call and talk with our staff for any insurance related questions.

Refill Requests

Kindly allow 24 hours for refill requests. We ask that you anticipate your refill needs and contact the practice early for such requests. Requests made after business hours will be addressed the next business day.

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