Forms
Make a New Patient Appointment
It is important to follow the steps below in this order to schedule an appointment.
Step 1: The legal guardian must call our intake department at 404-785-9350. This helps us register your child in our computer system before you fill out our e-take form. You are required to submit documentation of legal guardianship in case of divorce, adoption, foster placement or DFCS custody. Please fax this information to 404-785-9067 before completing Step 2.
Step 2: Fill out the e-take form in detail. Incomplete applications may cause a delay in scheduling services. If you do not have a computer to use, call 404-785-9350 to request a form be mailed to you.
Step 3: You will get an email after your form has been reviewed with a contact number to call and discuss your appointment. Programs may place you on a wait list until there is an opening. Some programs have longer wait times than others. Thank you for your patience.
Please allow a week for us to process the referral. We appreciate your patience.
Medical Records Request
Note: To get your child's medical records, you must fill out a HIPAA compliant authorization form. Any incomplete forms will be returned.
Medical Consent
Clinical Services and Educational Programs
To request an appointment information packet, please send an email to marcusreferral@choa.org and the packet will be emailed to you to complete and return to schedule an appointment.