Patient Information Sheets Click on the underlined item to open.
Disability Clients
Please print out this form ( two pages) and COMPLETE PRIOR TO YOUR ARRIVAL for your appointment. Please call the Doctor's office at 678-218-0320 for the allegations pertaining to your visit. Take your time and carefully complete the sections. If you have a nicely written or typed list of your medications, then bring that with you and write "SEE ATTACHED" in the medication section. Disability MAY have your medical information but the Doctor's office usually does not. This information is extremely important for your case.
This is the new I-693 revised 11/1/11. Please complete the top of page 1and also type your name on the top of page 2. On the bottom of page
1, please type our office information as follows: Diana M. Whiteman, MD 6278 US 29, Suite 110, Tucker, GA 30084 To Your Health Medical & Fitness, PC admin@toyourhealthmed.com / 6782180320
****** DO NOT SIGN IT OR DATE******** Bring all five pages with you and photo ID to your examination.
You may use the following standardized vaccination form for your health provider to complete and bring with you to your appointment. CLICK HERE > Vaccination (Immunization) form
School and Sports Physicals
There are two forms to prepare prior to your visit. 1. Patient information form 2. County physical form ( complete the parent / student portions). Bring the entire set of forms for your examination with the physician.
DOT Clients - There are two forms to complete prior to your arrival. 1. Patient information sheet 2. DOT form - please ONLY complete page one of this form and bring the entire set of forms for your examination with the physician.
Please remember to wear clean shoes and clothing for the appointment. You may park any large trucks across the street.
Vendors
Please print your school flier and then stamp or emboss with your official seal before distributing to your students. Please tell the student to bring their school ID and stamped flier in order for us to honor these prices. Have the student complete the Patient information sheet prior to arrival.
Parris & Associates Rheumatology patients should complete the following 8 pages of forms and bring with you to your first appointment. Completion of the forms IN ADVANCE can save you precious time in the office.
PATIENT FORMS