Patient Forms

×

Error message

  • Notice: Trying to access array offset on value of type int in element_children() (line 6551 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6551 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6551 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6551 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6551 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6551 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6551 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/common.inc).
  • Deprecated function: implode(): Passing glue string after array is deprecated. Swap the parameters in Drupal\gmap\GmapDefaults->__construct() (line 107 of /home4/flphafmy/public_html/trinity4kidsatl.com/sites/all/modules/gmap/lib/Drupal/gmap/GmapDefaults.php).
  • Deprecated function: The each() function is deprecated. This message will be suppressed on further calls in menu_set_active_trail() (line 2404 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/menu.inc).
  • Deprecated function: implode(): Passing glue string after array is deprecated. Swap the parameters in drupal_get_feeds() (line 394 of /home4/flphafmy/public_html/trinity4kidsatl.com/includes/common.inc).

Instructions

Please complete the documents by clicking on the applicable links below and filling in the text areas with the required information. Once you finish, print, sign and date, and present your patient form to the front office at the time of your appointment. Doing so in advance will save you from having to come one hour prior to your appointment to complete in our office.

Note: Abobe Reader is required to view the Patient Forms. To download Adobe Reader for free, you may click the button at the bottom of the page. Thank you for choosing our services, and have a great day. 

            FOR CHILDREN

New Patient Packet (Medical Only) [PDF]