NEW PATIENT FORMS

We look forward to assisting your family.

Prior to scheduling your new patient appointments we will need the below information filled out, completed and returned to our office

Please fill out the below PDF files so that we can create a patient profile and schedule you for your new patient appointment.

Files  can be faxed at 404-303-7837 or emailed to practiceadmin@therubincenterforautism.org

Demographic Sheet 

New Patient Questionnaire