For Your Convenience ...
**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.
Forms
PTP Referral Form (English) or, use our secure online form
PTP Informed Consent (English), or use our secure online form (includes Informed Consent and Health Screen)
PTP Informed Consent (Spanish)
PTP Authorization to Release/Receive Information (English), or use a secure online form
PTP Authorization to Release/Receive Information (Spanish), or use a secure online form in Spanish
PTP Medical Records Request Form (English) or, use a secure online form. Medical records > more info
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)
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.
Forms
PTP Referral Form (English) or, use our secure online form
PTP Informed Consent (English), or use our secure online form (includes Informed Consent and Health Screen)
PTP Informed Consent (Spanish)
PTP Authorization to Release/Receive Information (English), or use a secure online form
PTP Authorization to Release/Receive Information (Spanish), or use a secure online form in Spanish
PTP Medical Records Request Form (English) or, use a secure online form. Medical records > more info
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)
