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Forms

At Sandy Springs Internal Medicine, we want your visit to be as smooth and productive as possible. That’s why we offer secure patient forms online for you to fill out prior to your visit. Both new and returning patients can download and complete the following secure patient forms.

Our most popular service, the annual history and physical assessment, consists of a thorough evaluation of the patient’s medical history and a head-to-toe, comprehensive physical examination by your physician. For the medical history portion, we require patients to fill out a History and Physical Preparation Instructions form. Please download and fill out this form three to four days prior to meeting with your physician. Additionally, please plan on returning your completed form to our office three to four days before your appointment by faxing the document to 404-252-3720 or by securely emailing them to portalsupport@ssim.com.

If you have any questions or need additional assistance, please contact Sandy Springs Internal Medicine at 678-252-6395.

Female History and Physical Preparation Instructions (PDF)
You can securely download and fill out this form for your upcoming appointment. Additional instructions are available on the first page of this document.

Male History and Physical Preparation Instructions (PDF)
You can securely download and fill out this form for your upcoming appointment. Additional instructions are available on the first page of this document.

Medical Records Request Form (PDF)
You can securely download and fill out this form to request the release of your medical records.

Authorization for Disclosure of Protected Health Information (PDF)
You can securely download and fill out this form to authorize the disclosure of your protected health information.