Patient Forms for ExperCARE

Patient Forms

Make your first visit fast and efficient.

Patient Forms

Make your first visit fast and efficient.

To make your visit to ExperCARE as efficient as possible, we have provided the following patient forms for you to fill out before you arrive. Simply click on the appropriate link and the form will automatically download for you to print.

Notice of Privacy Policy

This notice describes how medical information about you may be used and disclosed, as well as how you can get access to this information.

Download Form

Registration Form

New patients need to provide personal and work related info, as well as insurance details and guarantor contacts.

Download Form

Consent Authorization

Patient consent assignment and authorization for treatment and notification of center policies.

Download Form

Parental Authorization

If a minor child will receive treatment when accompanied by someone other than the parent or guardian, or by himself or herself.

Download Form

Patient Forms

Patient Forms

Notice of Privacy Policy

Registration Form

Consent Authorization

Parental Authorization

Savannah – Mall Blvd

Savannah – Downtown

Richmond Hill

Pooler

Statesboro

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