Patient Center

Patient Forms

Please fill out these secure forms online and submit them directly to our office.

Family Practice Center welcomes new patients! We look forward to caring for your individual health concerns. Call for an appointment today, 404-256-1727.

Online New Patient Form

You can now securely submit New Patient information directly to our office using our HIPAA compliant Web form.

New Patient Registration Form

Online Existing Patient Forms

You can now securely submit Existing Patient information directly to our office using our HIPAA compliant Web form.

Existing Patient Registration Form

New Patient Form (PDF)

Save some time by filling out this form before your first visit.

Download New Patient Form

Existing Patient Form (PDF)

Update your existing patient file before you arrive so we can expedite your visit.

Download Existing Patient Form

Medical Record Release Form (Outgoing)

Authorization to release information to third parties, or release records to patient/guardian, or release records to patient.

Medical Record Release Form

Medical Release Forms (Incoming)

Authorization to release requested information from another Provider to Family Practice Center.

Medical Record Release Form

Insurance

The list below includes many of the companies with which we have commercial plan contracts. The list is not all-inclusive; therefore, if you do not see your company, please call or email us to verify that we are part of your plan.

 

 

Bill Payment

We accept cash and major credit cards. FPC will collect co-payments, co-insurance and deductibles at the time of service. If you have a balance with our office your payments will be applied to the oldest balance first. In the event your account has a credit on one service and a deficit for another, we reserve the right to transfer credits to any outstanding balances prior to issuing a refund.

Pay Online

Please feel free to call our Business Office at 404-256-1202 or email to billing@familypracticecenterpc.com with any questions.

Patient Portal

Our Patient Portal facilitates communication with our office by providing convenient 24 x 7 access from the comfort and privacy of your own home or office. Through our secure patient portal, you are able to:

  • Communicate with your doctor
  • Request prescription refills
  • Access your test results
  • Manage your appointments

If you already have an enrollment token, you may access the portal to login.

Access MyChart Patient Portal