New Patient Forms

Welcome to Georgia Highlands Medical Services, and thank you for joining us as a new patient! We look forward to serving you and partnering with you to improve you and/or your family’s health.

New Patient Registration Form (Online)

Here are a few reminders for your first visit:

  • Please fill out and submit the New Patient Form before your visit to speed up the check-in process. (If you aren’t able to fill the form out in advance, you can complete it when you arrive.)
  • Please try to arrive half an hour early to your first appointment so we can make sure everything is all set in our system.
  • Please bring your insurance card (if you have one).
  • Please bring a listing of all medicines you are currently taking.
  • Let us know about any special accommodations you may have. We offer foreign language interpreting services, wheel chair assistance, aids for patients with limited sight and hearing, etc.
  • Every time you visit, please tell us about any changes in your phone, address, etc.

You may be eligible to participate in our Sliding Fee program. If so, you can pay for services based on the size of your family and your family income. If you believe you may be eligible, you will need to complete a sliding fee application and will be required to present a picture ID and proof of household income. Staff will be able to assist you at any of our locations and will help make sure that you have the right documents.

The forms below can be printed and completed instead of the online form.

New Patient Registration Form (English)

Nuevo Formulario De Registro Del Paciente (Español)

Privacy practices:

Notice of Privacy Practices (English)

Aviso De Prácticas De Privacidad (Español)