New Patient Forms

New Patient Information

Hello, New Patient!

Please join us in making our office greener. Take a few minutes to fill out this confidential form below. Click the “Submit Form” button at the bottom, and your information will be sent to our office with secure encryption.

We strongly encourage you to fill in the form electronically. However, if the online form doesn’t work for you, you may download and print a hard copy to use. Please bring the completed form to your consultation appointment.

If necessary, you may download and complete either the Adult New Patient Form or the Child New Patient Form manually. If you opt to do so, you will need to bring your completed form to your consultation appointment.

2 Convenient Locations
1Gardendale

305 Mitchell Hill Rd.
Gardendale, AL 35071
205.631.6033

1Alabaster

100 South Colonial Dr. Suite 800M
Alabaster, AL 35007
205.621.1111

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