Surgical Specialists of Atlanta

4 Locations: Sandy Springs, Midtown, Alpharetta, & East Cobb

MENUMENU
  • Home
  • Surgeons
    • Iqbal Garcha, MD, FACS
    • J. Patrick Luke, MD, FACS
    • David M. Ruben, MD, FACS
    • Mark B. Wilkiemeyer, MD, FACS
    • Thomas W. Wood, MD, FACS
  • Surgeries
  • Locations
    • Alpharetta
    • East Cobb
    • Midtown Atlanta
    • Sandy Springs/Tower
  • News
  • Patient Information
    • Forms
    • Pay Bill Online
  • Patient Portal
MENUMENU
  • Home
  • Surgeons
    • Iqbal Garcha, MD, FACS
    • J. Patrick Luke, MD, FACS
    • David M. Ruben, MD, FACS
    • Mark B. Wilkiemeyer, MD, FACS
    • Thomas W. Wood, MD, FACS
  • Surgeries
  • Locations
    • Alpharetta
    • East Cobb
    • Midtown Atlanta
    • Sandy Springs/Tower
  • News
  • Patient Information
    • Forms
    • Pay Bill Online
  • Patient Portal

Forms

New Patient Forms

Please click on the links below, print out and complete the ALL of the forms below. Additionally, please bring your current insurance card and a photo ID to your first appointment.

New Patient Registration Forms

Existing Patient Forms

If this is your first visit in the new calendar year, you have had a change of address or changes to your insurance since your last visit, please complete the packet below and bring it with you to your appointment so that we can update your medical records.

Existing Patient Registration Packet


Optional Forms

Medical Records Release


Associated Brochure Downloads for Your Reference

Patient Rights and Responsibilities
HIPAA Notice of Privacy Practices
Partnership for Safety


Insurance

We accept most major health insurance plans, however it is your responsibility to contact your insurance carrier to verify coverage and benefits. Patients may be held financially responsible for payment of services should the insurance company deny responsibility. Be sure to bring your insurance card with you every time you visit Surgical Specialists of Atlanta. Notify the front desk whenever your insurance coverage changes so that the medical staff can accurately maintain your important medical records.

Our Locations

Sandy Springs
Midtown Atlanta
Alpharetta
East Cobb

Copyright© 2019 Northside Hospital Inc. All Rights Reserved.

Copyright© 2019 Northside Hospital Inc.
A Northside Hospital Physician Practice.
All Rights Reserved.
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