Completing Medical Forms

We are happy to complete forms such as marriage license, school/camp, adoptions, disability and FMLA. Due to the time and medical expertise involved, we charge a fee of $25.00 per form which will be collected prior to releasing the form. Please allow us 7 business days to complete your form and ask that you plan accordingly. It will be your responsibility to complete your portion of the form and return it to the appropriate institution.

Forms (pdf)

  • Patient Information Form
  • Medical History Form
  • Medical Records Release Form: Please complete and send this form to your previous health care provider. This helps us gather your records and will make your visit more efficient.
  • Notice of Privacy Policies
  • Financial Policy

*To read and print forms, use the free and easy-to-use Adobe Acrobat Reader.

Provider Spotlight

Sally Brumbill, PA-C

Sally_smallSally Jay Brumbill is a 1986 graduate of Emory University School of Medicine’s Physician Assistant Program. While she is board certified in primary care, she has dedicated her career to women’s healthcare and has practiced in the Northside area since 1990, joining Women’s Health Associates in 1996.

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