Wednesday, March 10, 2010
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Download Patient Forms

Use this form to have copies of your medical records sent to our office:
Release of Records form

If you would like to save time during your first visit to us, fill out these forms and bring them with you:
History & Physical form
Privacy form
Profile form

Homewood Plaza, 3125 Independence Drive, Suite 210, Homewood AL 35209
One Nineteen Health & Wellness Center, 7191 Cahaba Valley Road, Suite 203, Birmingham AL 35242
Phone 205-943-1197 | Fax 205-879-2995