To expedite your child’s visit, please print and fill out the following forms beforehand.
Initial History Questionnaire – English
Initial History Questionnaire – Spanish
Patient Information and Income Verification- English
Patient Information and Income Verification- Spanish
Well-Child Checkup Patients Only
Tuberculosis- Lead Questionnaire- English
Tuberculosis- Lead Questionnaire-Spanish
Do you have questions about Well Child Check-ups? Please call 770-514-2300.
Please Note: *If you arrive more than 15 minutes late for your appointment, you will need to reschedule for another time.
What insurance do you accept for services?
Currently, Cobb & Douglas Public Health accepts these commercial insurance providers.