Putting Relationships at the Forefront of the Healthcare Experience

New Patient Application

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Please complete the new patient application below and either fax it to us at (256) 534-7268 or drop it off at our office.  (Please note: we are not accepting new Medicare or United Health Care patients at this time).

New Patient Packet

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Once your application is approved, please complete the new patient packet in order for us to set up your initial appointment.  You can drop off your new patient packet, fax it or mail it to us.

new patient application

New Patient Application (docx)

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New Patient Packet

New Patient Packet PDF (pdf)

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