Our Concern is Maintaining Your Health         
Return to our main pageReturn to our main page
Learn about Our Medical CareLearn about Our Medical Care
Learn about Our DoctorsLearn about Our Doctors
Patient LibraryPatient Library
FormsForms
Office hours and maps to our locationsOffice hours and maps to our locations
Office InformationOffice Information
Link to the Alzheimer`s Association Web SiteLink to the Alzheimer`s Association Web Site
Privacy PracticesPrivacy Practices
The Kaufmann Clinic, Inc. - Internal Medicine
Forms

Click on a form below to view. It will open in a separate window suitable for printing. Please print the forms and fill in all applicable information. Remember to bring these with you to your appointment.

Patient Information Form
Medical History Form
Consent Agreement
Authorization to Use and Disclose Health Information
HIPAA Acknowledgement Form

You will need Adobe's Acrobat Reader for viewing these items. Most computers have Acrobat, but is available for FREE by clicking the button below:
Get Acrobat Reader



Send e-mail to The Kaufmann Clinic, Inc.


The Kaufmann Clinic, Inc. * Internal Medicine
Patient Account Inquirie`s (for both offices): 770-874-2765 or 770-874-2766
E-mail: info@thekaufmannclinic.com
Midtown Office:
Crawford Long Medical Office Tower
550 Peachtree Street, NE, Ste. 1700
Atlanta, GA 30308
Office: 404-881-9727
Fax: 404-523-9184 		  North Office:
2001 Professional Way, Ste. 220
Woodstock, GA 30188
Office: 770-926-7411
Fax: 770-926-0452