Forms
New Patient Forms Package
All of our required new patient forms are provided in one PDF file for your convenience. In order to limit file size and reduce paper waste, the Midtown West Medical Privacy Policy is not included in the package; this policy is available here online. You may read the Privacy Policy online in order to complete the required Receipt of Privacy Policy form included in the New Patient package, or you may request a paper copy at the office.
Promissory Note
The Promissory Note form is provided for the convenience of patients who have a pre-arranged payment agreement with us. Please contact our Practice Manager, Suzanne Combs, at 404.817.0062 before using this form.