New Patient Forms

To schedule an appointment, kindly ask your referring physician to fax the referral information. Before your first visit, please take a moment to print and fill out the new patient information form, which is linked below. Bringing the completed form to your initial appointment will help ensure a smooth and efficient check-in process, allowing us to focus on your care right from the start. If you have any questions about the form or the referral process, feel free to contact us for assistance.

Adult Registration Forms
Child Registration Forms
Therapy Intake Forms
SNP Out-of-Pocket Fees

Prioritizing cognitive wellness is not just about maintaining mental sharpness—it's about empowering yourself to live a fuller, healthier life.

Additional Information and FAQ

To ensure a smooth and efficient appointment process, we ask that all new patients complete the necessary forms prior to their visit. Below are answers to common questions about the new patient form and how to submit it.

Completing the new patient form helps us gather important information about your medical history and current concerns. This ensures that we are fully prepared for your appointment and can provide the best possible care.
You can download the form from our website, complete it, and either bring it with you to your initial appointment or fax it to us at the number provided.
If you're having difficulty filling out the form or have any questions, please contact our office, and we’ll be happy to assist you. We can also provide assistance during your appointment if needed.

Call (912) 349-4055 To Get Started

To make an appointment, please have the referring physician fax referral information to (912) 244-6500. Please print out and complete the new patient information linked below and bring it to the initial appointment.
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