354 Newnan Crossing Bypass, Suite 205, Newnan, GA 30265 Mon–Fri · 7:00am–5:00pm
(770) 520-8561 Book an Appointment

Patient Forms

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

New to Newnan 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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Download the PDF

Prefer to handle it another way? Complete this form through the Patient Portal, or call (770) 520-8561 and our front desk will have a copy ready at your visit.

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