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Blairsville Internal Medicine
  • (706) 745-5541
After Hours Care
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    • After Hours Care

Forms

Important Forms and Resources for Our Patients

Patient Forms

  • 1

    New Patient Letter

  • 2

    Patient Registration

  • 3

    Health History Questionnaire

  • 4

    Consent Patient Medication History

  • 5

    Authorize for Release of Records to BIM

  • 6

    Authorize for BIM to Release Records to Other Provider

  • 7

    Financial Policies

  • 8

    Privacy Practice

  • 9

    Privacy Practices Acknowledgement

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Site Links

  • Home
    • How to Make a New Appointment
    • What to Expect on Your First Visit
    • What to Bring
    • Our Goal
    • Logging On to Our Patient Portal
    • Reminders
    • Our Medical Services
  • Providers & Staff
  • Forms
  • FAQs
  • Insurance
  • Contact Us
    • After Hours Care

Get In Touch!

(706) 745-5541

(706) 745-0282

374A Pat Haralson Memorial Dr
Blairsville, GA 30512

Lab: Mon-Thur: 7:00am – 5:00pm
Office: Mon-Thur:8:00am – 5:00pm

Patient Portal

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