New Patient Forms

Good Faith Estimates

What is a Good Faith Estimate?
  • A Good Faith Estimate (GFE) is an estimate of your expected bill for medical items/services. It is your right to receive a GFE for the total expected cost of any non-emergency items or services, including office visits, labs, and medical tests or procedures.
  • You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services.
  • You can ask for any health care provider or facility for a Good Faith Estimate before you schedule an appointment or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
  • If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.
  • Make sure you save a copy of your Good Faith Estimate and the bill.
  • How can I pay a bill or reach the Billing Department?

  • To pay your Georgia Highlands Medical Services bill, please call (770) 887-1668.
  • More Information:

  • For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers or call 1-800-985-3059.
Welcome To Georgia Highlands Medical Services

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.

Sliding Fee Discount Program

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.

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.

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

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