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Patient Forms

Click on the appropriate forms below. If you are new patient, please complete the first 3 forms below and bring them to your appointment, along with patient(s) insurance card, photo ID of patient/parent/guardian, and a method for co-payment. We accept all major credit/debit cards and cash payment. We DO NOT accept checks. This will help speed up your check in process. Thanks for your cooperation.

 

 

* The Consent For Use Or Disclosure of Protected Health Information For Treatment is a form if you want a family member to call on your behalf.

* The Authorization For The Release or Exchange of Information is a form if you want Jydes to request or exchange information from another physician or facility.

* The Notice of Privacy Practice is for your records. You will sign that you were given the form in the New Patient Paperwork.

Our Locations

Norcross

(Horizon at Norcross)
4720 Peachtree Industrial Blvd
Suite 4102
Norcross, GA 30071
Phone: 770-686-3232

Alpharetta

(Old Milton Commons)
3550 Old Milton Parkway
Alpharetta, GA 30005
Phone: 770-674-0543

Buford

3966 S. Bogan Rd. N.E. 
Buford, Ga 30519
Phone: 678-765-8276

Dacula

(Hamilton Mill Station)
2089 Teron Trace
Suite 225
Dacula, GA 30019
Phone: 678-804-9944

Dawsonville

(Premier Office Park)
139 Prominence Court
Suite 130
Dawsonville, GA 30534
Phone: 706-531-1364

Get Direction

 

Hours of operation

Monday – Friday 9:00am – 5:00pm
Saturday 9:00am – 1:00pm

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