Medical Forms You Need to Fill Up Before Your Appointment

Please complete all appropriate forms before your scheduled appointment. Arriving at least 15 minutes before initial appointment is requested.

Please find our easily accessible form below for your benefit as a patient. All forms are printer friendly for your convenience to make your appointment run more efficiently at Jay Medical Clinic.

New Patient Medical History Form

New Patient Data Sheet

Notice Of Privacy Practices

HIPPA Privacy Acknowledgement Form

JAY Medical Patient Consent Form

JAY Medical Patient Financial Policy

Medical Records Release to Jay Medical Clinic

Medical Records Release Request from Jay Medical Clinic

Health Risk Assessment for Medicare Patients

Sports Physical Form

Patient Information Update Form

Georgia Advance Directive For Health Care

Prescription Refill Policy Form