Becoming an FMG Patient:

 

Becoming a patient at Functional Medicine Georgia requires a serious, commitment of your time, focus, and energy as well as a financial investment in your health. FMG does not accept insurance. The 'Health Questionnaire and Consent Forms must be completed and returned to the office before your first appointment will be booked. The questionnaire and consent forms will be reviewed by Doctor Doniparthi, prior to your visit. 

Health Questionnaire 
Consent Forms

Directions:

 

  1. Please click to download the document and complete in its entirety.

  2. Return document to FMG using ONE of the following methods:

 

  • Mail to: Functional Medicine Georgia

  401 S Main St Suite C1  

  Alpharetta, GA 30009

 

  • Fax to: 678-242-0406

Attention: Office Manager

Medicare Private Contract

Attention Medicare Patients:

 

All Medicare patients are legally required to sign a private contract in order to be seen at FMG, per the Center of Medical Services (CMS).

 

Notice of Privacy Practices Acknowledgement