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Northside Cherokee Pediatrics - Towne Lake fax number

(770) 852-7721

Pediatrics

Used for: Medical records submission and immunization forms (e.g., medical history and immunization forms).

Fax destination details

Department
Pediatrics
Purpose
Medical records submission and immunization forms (e.g., medical history and immunization forms).
Form
Medical History and Immunization Form — Medical History Immunization Form
Address
900 Towne Lake Parkway, Suite 306, Woodstock, GA 30189
Voice phone
770-852-7720

Before you send

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  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
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Complete the patient medical history, social history, development, and immunization sections prior to the visit; the form includes consent for immunizations and GRITS reporting.

Official form instructions are published as a downloadable file on the organization's website.

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