OB-GYN Associates of Marietta, Georgia logo for print
MARIETTA Location: 699 CHURCH STREET • SUITE 300 • MARIETTA, GA 30060 • 770-422-8700
WOODSTOCK Location: 100 STONE FOREST DR • SUITE 150 • WOODSTOCK, GA 30189 • 678-445-3555

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Patient Center

For your convenience, we have made several patient forms available to be downloaded and printed prior to your visit. By completing these forms in advance, you will help us to serve you in a more efficient manner.

In order to access the forms, you must have Adobe Acrobat Reader installed on your machine. 
All new gynecological patients must fill out forms 1-5. Or download the following forms packet:

All new pregnant/ob patients must fill out forms 1-6.  Or download the following forms packet:

Individual Forms

  1. Patient Registration Form
    (complete first visit and annually) 
  2. Protected Health Information Form
    (complete first visit and annually)
  3. Health History Form
    (complete first visit)
  4. Patient Privacy Acknowledgement
    (complete first visit) 
  5. Financial Policy
    (complete first visit)
  6. Family Genetic History Questionnaire
    (complete first visit for each pregnancy) 
  7. Notice to Patients With Medicaid Coverage
    (C.M.O. Provider information and other insurance coverage disclosure)
  8. Release of Records
    Release of information for OBGYN ASSOCIATES is managed by HealthPort.
  9. Wellstar Pre-Admission
    (print and fax to Hospital for Pre-Admission)
  10. Medicare Patient Self Pay Fee Schedule
    effective February 1, 2015

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