112 Wilshire Village Drive, Peachtree City, GA 30269 Mon–Fri · 7:00am–5:00pm
Book an Appointment (770) 676-DERM

Patient Forms

Authorization for Use or Disclosure of Protected Health Information to DSWG PC

New to Peachtree City Dermatology? Use this form to authorize your previous doctor to transfer your medical records to our practice (Dermatology Specialists of West Georgia, P.C.).

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Prefer to handle it another way? Complete this form through the Patient Portal, or call (770) 676-3376 and our front desk will have a copy ready at your visit.

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