(678) 393-3374

Sunita Gupta MD PC

Sunita Gupta MD PCSunita Gupta MD PCSunita Gupta MD PC

Sunita Gupta MD PC

Sunita Gupta MD PCSunita Gupta MD PCSunita Gupta MD PC
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    • Home
    • Message form
    • New patient
    • TELEHEALTH
    • Forms and Resources
      • FORMS
      • Resources
      • FAQ
    • Staff

(678) 393-3374


  • Home
  • Message form
  • New patient
  • TELEHEALTH
  • Forms and Resources
  • Staff

NEW PATIENT INFORMATION

NEW PATIENT INFORMATION

NEW PATIENT INFORMATION

Please print and fill out the forms below, as applicable to you. 


  1. TIME-Please arrive 30 minutes prior to the appointment time.
  2.  Please bring a valid ID card and  an Insurance card. 
  3. PAYMENT-We only accept Visa, Discover, and MasterCard credit cards. We do not accept Checks and American Express card.​ 
  4. Please fill out the Registration form for new patient.
  5. Also fill out Release of information form, if needed for previous treatment records.
  6. Please review the Clinic Orientation and HIPPA policy.

NEW PATIENT INFORMATION

NEW PATIENT INFORMATION

Downloads

Registration form New Patient (pdf)Download
Release of Information form (pdf)Download
Notice of Privacy Practice HIPPA -please read (pdf)Download
Orientation to the policies-please read (pdf)Download
ADHD Self-Report form (ASRS) (pdf)Download
ADHD Observer form to be filled by family/teacher (pdf)Download

Rating Scales

Bipolar Disorder-MDQ form (pdf)Download


Psychiatrist in Alpharetta,GA 

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