Please check all that apply. **PLEASE NOTE: If this is an urgent visit, we recommend contacting our office by calling or texting 770-917-2221. Response to requests may take 48-72 hours.

Please let us know what day(s) and time(s) you would prefer to have your appointment. THIS IS NOT A GUARANTEE OF YOUR APPOINTMENT UNTIL OUR STAFF CONTACTS YOU AND CONFIRMS IT BY PHONE, TEXT OR EMAIL.

Please let us know if you are a new or existing patient.

Insurance appointments may take up to 3-5 business days for verification. We will contact you by phone, text or e-mail if we cannot confirm your insurance. Please click on the following link to confirm the insurances that we accept.

PLEASE NOTE: If you prefer a faster response, please allow our office to communicate by text.

You are required to read the COVID-19 Protocol. For FOR NEW PATIENTS, in order to be seen at our clinic, you must complete the online form BEFORE the appointment. Please check Yes or No if you agree to the requirements. If you check No, we will place your name on a reserve list when we are able to lessen our restrictions on safety guidelines recommended by the CDC and AOA.