Patient Info

Bring the following to each appointment:

• Health Insurance Card
• Drivers License
• Method of Payment
• Copay

If you are more than 15 minutes late for an appointment, you may be marked as a NO SHOW. There will be a $50.00 no show/late cancellation fee if appointment not cancelled within 24-hours.

All patients must log onto the portal and complete their paperwork prior to coming to their appointment.

Obstetrical Patient Forms

OB Financial Policy

View Form

OB Information Packet

View Form

Other Forms and Information

All Patients must log onto the portal and complete paperwork prior to coming to their appointment. Thank you.

Appointments:

• Please arrive for your appointment 15 minutes early. • Please inform the receptionist of any demographic changes such as name, phone number, address etc. Failure to notify us immediately of changes in demographic information, financial status and/or insurance coverage may result in you being responsible for payment of any services not covered by your carrier.

Same Day Appointments:

• We DO NOT accept walk-ins. • If you feel your issue is urgent, call our phone nurse (ext 3022) , who will discuss your urgency with the doctor on call.

• If you are experiencing an emergency, call 911 or go to the ER.

Prescription Refills:

• All refills requests must go through our phone nurse (ext 3022) or may be requested at your appointment. • You must be up to date on your annual exam for continued refills.

Minor Patients:

• The parents or guardians accompanying a minor are responsible for providing current insurance information on the minor as well as the payment in full for services provided. • Minors between the ages of 16-18 must have a Pre-Authorization for Medical Treatment form signed by the parents or guardians on file if they arrive unaccompanied for an appointment

• Minors under under the age of 16 must have an Authorization for Agent of Proxy to Consent for Medical treatment signed by the parent or guardian for each visit. • In compliance with HIPAA regulations, we are unable to discuss any details of services rendered or to produce an itemized bill for any parties that are not the patient, unless otherwise documented.

• All minors must have a parent/guardian present at the time of check in as well as authorization to for medical treatment and auth for agent of proxy.

Medical Records:

• A medical records release form must be on file before we can legally release your records. You can download our release form above. • All records will take 7-10 business days to process once a release form is received.

• Medical record fees are as follow: 1. FREE if sent to another doctors office.

2. $75 if requesting a personal copy. 3. Insurance companies, law offices, etc will vary depending on the number of pages.

FMLA

We charge $75 for FMLA to be completed and can take up to 14 business days to complete. This is a once per pregnancy fee.

Georgia Obstetrics and Gynecology

✆ Phone (appointments): 404-256-2943

✆ Phone (general inquiries): 404-256-2943

Address: 5780 Peachtree Dunwoody Road, Interchange Building, Suite 320, Atlanta, GA 30342