New Patient Forms If you are a new patient, you will need to complete the forms below before seeing a health care provider. You can print and fill out these forms in the comfort of your home and avoid having to come earlier for your appointment to do paperwork.
Authorization to Obtain and Release Information
Care Coordination Consent
Consent for Services-Education and Prevention Services
Behavioral Health Consent Form
Eligibility Forms An eligibility appointment is very important in order to assess whether or not you qualify for various programs and/or financial aid from the government. Our Patient Benefit Specialists are highly-trained and will match you with the best options you have so that you will benefit from the most affordable health care solution. Eligibility Requirements
Patient Bill of Rights and Responsibilities We take our responsibility towards you as a patient very seriously and expect the same in return. Please read the "Patient Bill of Rights and Responsibilities" to understand our expectations of you and our commitment to you.
Patient Bill of Rights and Responsibilities
Protected Health Information
General Information: (404) 870-7700STI Testing: (404) 870-7722Volunteer: (404) 870-7764Comment Line: (678) 999-1212(Anonymous)
1605 Peachtree Street NE, Atlanta, GA 30309-2955(404) 870-7700
This web site contains HIV prevention information and may not be suitable for all audiences.