Patient Forms


New Patient

Please download and complete the New Patient Registration Forms and bring them with you to your first appointment along with your medical insurance card and photo ID. If you are unable or need assistance, we ask that you please arrive at our office 30 minutes prior to your scheduled appointment time.


New Patient Registration Forms (English) New Patient Registration Forms (Spanish) Patient Medical History/Intake Form (Bilingual)

Existing Patient

If this is your first visit in the new calendar year, you have had a change of address or changes to your insurance since your last visit, please complete the packet below and bring it with you to your appointment so that we can update your medical records.


Existing Patient Registration Forms (English)

Optional Forms

Medical Records Release

Insurance

We accept most major health insurance plans, however it is your responsibility to contact your insurance carrier to verify coverage and benefits. Patients may be held financially responsible for payment of services should the insurance company deny responsibility. Be sure to bring your insurance card with you every time you visit North Atlanta Breast Care. Notify the front desk whenever your insurance coverage changes so that the medical staff can accurately maintain your important medical records.




Our Hours:

Monday – Thursday:
8:00 AM — 4:00 PM
Friday:
8:00 AM — 12:00 PM

*Please note that we are closed for lunch daily from 12:00 PM — 1:00 PM*

Book an appointment

Northside Hospital Cancer Institute



Request an appointment