Patient Center

Patient Forms

Welcome to Family Practice Center’s secure patient forms. You can fill out these secure forms right here online and submit them directly to our office. If you need to update your patient forms, you can sign back in to your intakeQ account and update any information you need to.

We welcome new patients and same day appointments as well! We look forward to caring for your individual health concerns and needs. Please, call our office if you have any questions or need assistance at 404-256-1727.

New Patient Form (PDF)

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

Download Patient Form

Existing Patient Form (PDF)

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

Download Existing Patient Form

New Patient Form (PDF/Spanish Version)

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

Download Patient Form Spanish Version

Existing Patient Form (PDF/Spanish Version)

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

Download Existing Patient Form Spanish Version

Medical Record Release Form (Outgoing)

Authorization to release information to third parties, 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 and is subject to frequent change. Therefore, if you do not see your insurance company, please call or email us to verify that we are part of your insurance plan.

 

 

Bill Payment

Family Practice Center accepts cash and major credit cards. We 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 24/7 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 patient portal to login.

Access MyChart Patient Portal

Privacy Notice

HIPAA Notice of Privacy Practices

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