Forms
New Patient Forms and Agreements
Please print and complete all Forms and Agreements and return them at your initial Visit. You may access our Patient Portal to complete your basic information and medical information online. You will receive an email invitation that will allow access to the patient portal.
- Patient Portal
New Patients
Medical Release Form
Medical Records Release (Authorization to Release Medical Information)
Existing Patients
Existing Patient May Request Additional Information through the Patient Portal.
Referral from Medical Professionals
Copyright © 2015 North Georgia Pain Clinic
Legal Disclaimer — the information contained on North Georgia Pain Clinic's website is not intended as rendering medical advice nor as a substitute for seeking professional medical assistance. No relationship between North Georgia Pain Clinic and its practitioners may be created through the use of North Georgia Pain Clinic's website. Any individual with specific questions regarding his/her individual health or treatment options should contact North Georgia Pain Clinic to determine if an appointment with one of its practitioners would be appropriate or in the event of an emergency, dial 911.
Legal Disclaimer — the information contained on North Georgia Pain Clinic's website is not intended as rendering medical advice nor as a substitute for seeking professional medical assistance. No relationship between North Georgia Pain Clinic and its practitioners may be created through the use of North Georgia Pain Clinic's website. Any individual with specific questions regarding his/her individual health or treatment options should contact North Georgia Pain Clinic to determine if an appointment with one of its practitioners would be appropriate or in the event of an emergency, dial 911.