New Patient Registration Form
Let's Communicate uses HIPAA-compliant electronic health records. All information provided will be confidential. Please fill out this form for each patient to be registered. You will need your insurance cards ready to take a picture of the front and back of the card. Once this form is completed, you will be redirected to our HIPAA Patient Consent Form to complete and sign. Once the HIPPA Consent Form is complete, you will be redirected to our Patient Medical History Form. All three forms need to be completed to make your first appointment and will take approximately 5-10 minutes to complete. All forms completed will be emailed to us for processing and emailed to you for your records. Once all forms have been processed, you will receive a call from our scheduler. For questions, please call (678) 963-0694. These forms are easy to complete on a mobile device or any computer.
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