Forms

New Patient Forms

Please download and complete the New Patient Registration Forms Insurance Requirements, Protected Health Information Authorization and Medication and Prescription Refill Policy and bring them 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.

New Patient Registration Packet

Medication and Prescription Refill Policy


Existing Patient Forms

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

Patient Registration Packet


Optional Forms

If you would like a copy of your medical records, please complete the form below and fax it to us at (678) 445-0927.

Medical Records Release Form


Associated Brochure Downloads for Your Reference

Patient Rights and Responsibilities
HIPAA Notice of Privacy Practices
Partnership for Safety Information Guide

In order to view or print these forms you will need Adobe Acrobat Reader.

Office Locations

Showing 3 results
Towne Lake Primary Care - Bridgemill
10515 Bells Ferry Road
Suite 200
Canton, GA 30114
770-704-6474 Get Directions Primary Care Monday: 8:00 a.m. - 4:00 p.m.
Tuesday: 8:00 a.m. - 4:00 p.m.
Wednesday: 8:00 a.m. - 4:00 p.m.
Thursday: 8:00 a.m. - 4:00 p.m.
Friday: 8:00 a.m. - 4:00 p.m.
Closed for Lunch: 12:00 p.m. - 1:00 p.m.
Towne Lake Primary Care - Holly Springs
684 Sixes Road, Suite 105
Holly Springs, GA 30115
(678) 388-5170 Get Directions Monday: 8:00 a.m. - 4:00 p.m.
Tuesday: 8:00 a.m. - 4:00 p.m.
Wednesday: 8:00 a.m. - 4:00 p.m.
Thursday: 8:00 a.m. - 4:00 p.m.
Friday: 8:00 a.m. - 4:00 p.m.
Closed for Lunch: 12:00 p.m. - 1:00 p.m.
Towne Lake Primary Care - Woodstock
900 Towne Lake Parkway
Suite 410
Woodstock, GA 30189
678-445-0819 Get Directions Primary Care Monday: 8:00 a.m. - 4:00 p.m.
Tuesday: 8:00 a.m. - 4:00 p.m.
Wednesday: 8:00 a.m. - 4:00 p.m.
Thursday: 8:00 a.m. - 4:00 p.m.
Friday: 8:00 a.m. - 4:00 p.m.
Closed for Lunch: 12:00 p.m. - 1:00 p.m.