For Your Convenience ...
Forms
PTP Client Intake Forms (PDF in English) or, use a secure online form.
PTP Client Intake Forms (PDF in Spanish)
PTP Referral Form (PDF in English) or, use a secure online form.
PTP Authorization to Release/Receive Information (PDF in English) or, use a secure online form.
PTP Medical Records Request Form (PDF in English) or, use a secure online form.
Brochures
PTP Short Brochure (English)
PTP Short Brochure (Spanish)
PTP Full Brochure (English)
Georgia Medicaid Applications
Georgia Medicaid Eligibility & Application Instructions
Georgia Medicaid Application (English)
Georgia Medicaid Application (Spanish)
**IMPORTANT**
Fillable forms must be downloaded and saved to your computer before entering your information. We recommend opening and completing form files using Adobe Acrobat Reader DC.
PTP Client Intake Forms (PDF in English) or, use a secure online form.
PTP Client Intake Forms (PDF in Spanish)
PTP Referral Form (PDF in English) or, use a secure online form.
PTP Authorization to Release/Receive Information (PDF in English) or, use a secure online form.
PTP Medical Records Request Form (PDF in English) or, use a secure online form.
Brochures
PTP Short Brochure (English)
PTP Short Brochure (Spanish)
PTP Full Brochure (English)
Georgia Medicaid Applications
Georgia Medicaid Eligibility & Application Instructions
Georgia Medicaid Application (English)
Georgia Medicaid Application (Spanish)
**IMPORTANT**
Fillable forms must be downloaded and saved to your computer before entering your information. We recommend opening and completing form files using Adobe Acrobat Reader DC.
