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. 

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

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

Demographic Sheet 

New Patient Questionnaire 

FOR COMPREHENSIVE DIAGNOSIS AND COORDINATION OF CARE

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I. LESLIE RUBIN, MD.
Developmental Pediatrician 

750 Hammond Drive  

Building 1 Suite 100  

Atlanta, GA 30328

Phone: (404) 303-7247 
Fax # (404) 303-7837

practiceadmin@therubincenterforautism.org

Office hours are:
Monday and Thursday :
9:00 am - 4:00 pm
Wednesday :

10:00am- 3:00pm

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