New Patient Information

  New patients at Southern Medical Group are asked to complete several important questionnaire forms. This information is needed to assure you will receive the best medical care.

  When you arrive for your first appointment you will be asked to complete a general information form. This information relates to basic family and financial information. Your physician will request that you complete a medical history form and the receptionist will photocopy your insurance cards.  HIPAA privacy forms will also be completed, per new federal law.

  These forms are available for printing. Click on the links below to view them. They are in Adobe Acrobat format (PDF):

New Internal Medicine Patients

Southern Medical Group Internal Medicine Welcome Sheet

Request for Limitations and Restrictions of Protected Health Information

Authorizations for Release of Protected Health Information

Internal Medicine New Patient Personal History

New Cardiology Patients

Southern Medical Group Cardiology Welcome Letter

Request for Limitations and Restrictions of Protected Health Information

Cardiology New Patient Evaluation Form

Cardiology New Patient Information Form

HIPAA Forms (All New Southern Medical Patients)

HIPAA Notice of Privacy Practices for Protected Health Information

HIPAA Acknowledgement of Notice of Privacy Practices 

  Finally, if you have any medical records, X-rays, or other information from a previous or referring physician, be sure to bring copies for your SMG physician to review. Past medical records may be helpful to your physician in determining your present health status.

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