New Patient Information

As new patients to the Emory Clinic, you will be asked to provide personal and insurance information. Please be prepared to provide this information when you schedule your appointment or we may contact you by telephone prior to your visit. If you are already an established patient and your information has changed, please arrive for your appointment at least 30 minutes early to allow us to update your information.

For your convenience, we have attached the forms you will be asked to complete and sign when you arrive for your first appointment. You may print these forms and complete them in advance if you like. Doing so will save time and paperwork for you on the day of our appointment. The first form is the Pre-registration Information. This form will need to be completed, signed and accompanied by your current insurance card if applicable. The second form is Initial History Form and should be completed by all patients. The third form is an HIV Review and will only need to be completed by HIV patients.

Because our clinic receives federal Ryan White funding, HIV patients are also required to provide certain income and residency documentation. The Financial Verification letter provides details on what is needed. Read more about the Ryan White Program at Emory University Hospital Midtown.

If you have questions about the forms, leave the areas in question blank. We will go over the forms with you in detail when you arrive for your appointment.

For your privacy, we ask that you do not complete these forms on-line.