Registration and Medical Forms

Print and fill out the requested forms prior to your appointment.

New Patient Forms

Please print and complete.

Link to Form

HIPAA acknowledgement signature sheet. Please sign after you view the HIPAA informed consent.

Link to Form

Please print and complete.

Link to Form

Personal Health Information Form (for age 18 and over, consent to contact and speak with other persons besides the patient).

Link to Form

  HIPAA & PHI Information

HIPAA Informed Consent Information for all patients.

Link to Form

HIPAA acknowledgement signature sheet. Please sign after you view the HIPAA informed consent.

Link to Form

  Physicals (Over 18)

If your appointment is with Dr. David Boaz, please print this form and complete prior to your appointment.

Link to Form

Instructions for an ADULT complete physical. If you have any questions, please contact our office.

Link to Form

  Medical Release Forms

Release for South Forsyth Family Medicine & Pediatrics to receive your records.

Link to Form

Records release to be sent to another physician or patient. Fees may apply.

Link to Form

Information about Personal Health Records, the HIPPA Privacy Rule, and patients rights and disclosure rules.

Link to Form

  Miscellaneous Forms

Consent to vaccinate. Must be completed for all patients 18 and under.

Link to Form

Refusal to Vaccine. Instructions on how to complete and form to fill complete with your physician. This form is for Adults and Children.

Link to Form