Please download, print and complete BOTH the New Patient Registration Forms AND the New Patient Medical History Forms below and bring the documents with you to your first appointment along with your medical insurance card and photo ID. If you are unable or need assistance, we ask that you please arrive at our office 30 minutes prior to your scheduled appointment time.

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 forms below and bring it with you to your appointment so that we can update your medical records.

If you would like a copy of your medical records, please complete the Medical Records Release Form below.

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 North Georgia OB/GYN Specialists. Notify the front desk whenever your insurance coverage changes so that the medical staff can accurately maintain your important medical records.

Payment is due at the time of service. This includes copays, deductibles, co-insurance, outstanding balances, and services not covered by your insurance.

North Georgia OB/GYN Specialists accepts cash & checks, VISA and MasterCard.

Important Information

• Patients can create an account or go directly to Pay Now
• Please be ready to enter your Date of Birth in MMDDYY format and the account number as it appears on the statement with the 3 digit database at the end.
• Example: Statement shows account 111111-XYZ (XYZ = Centricity Database). Enter as 111111XYZ on-line.
• Continue to follow the on-line prompts to enter credit card information and to have receipt e-mailed.
• For any questions, please have patients call the Galen Patient Services team at (678) 223-7932 or e-mail NSHPatientConcerns@galenadvisors.com

Please note this is not for processing any time of service money that is posted under an NCPY charge, please continue to use your current office processes for those funds.