Patient Forms

Thank you for choosing Northside Gwinnett Surgical Associates for your surgical needs. Please download and complete the New Patient Registration Forms and bring them with you to your first appointment, along with your medical insurance card and photo ID. If you are unable or need assistance, we ask that you please arrive at our office 30 minutes prior to your scheduled appointment time.

New Patient Forms

• New Breast Patient Forms (Please complete the My Gene History screening before your appointment)
• New General Surgery Patient Forms
• New Parathyroid Patient Forms
• New Thyroid Patient Forms
• New Varicose Vein Patient Forms

For Existing Patients

If this is your first visit in the new calendar year, you have had a change of address or changes to your insurance since your last visit, please complete the form below and bring it with you to your appointment so that we can update your medical records.

• Patient Registration Forms
• Practice-Specific Registration Form

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Optional Forms

• Medical Records Release

Associated Brochure Downloads for Reference

• Patient Rights & Responsibilities (Spanish)
• HIPAA Notice of Privacy Practices (Spanish)
• Partnership for Safety Information Guide (Spanish)