1700 Northside Drive NW, Suite A3

Atlanta, GA

404-351-1800

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Online Forms

Back To Basics offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us (404-351-1040) your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Forms - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Patient Intro Form

Informed Consent

Financial and Cancellation Policy

Auto Accident Forms - Required ONLY if you were in an accident

 If you have been involved in a auto accident, we would like to get a little more information from you. Please also fill in the forms hereafter as well as the New Patient Health History Forms.

Accident Information

Authorization for Release of Records and Physician's Lien



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Locations

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Office Hours

Our Regular Schedule

Monday:

8:00 am-1:00 pm

3:00 pm-7:00 pm

Tuesday:

8:00 am-1:00 pm

3:00 pm-7:00 pm

Wednesday:

8:00 am-1:00 pm

3:00 pm-7:00 pm

Thursday:

8:00 am-1:00 pm

3:00 pm-7:00 pm

Friday:

8:00 am-1:00 pm

3:00 pm-7:00 pm

Saturday:

9:00 am-2:00 pm

Sunday:

Closed