Registration Forms

These forms can be used for patients at PrimeTime Pediatrics as well!

For the fastest check-in experience please use the online forms below to register for services, this will help expedite the process. We have downloadable forms as well.

New Patients will need to fill out two forms, the New Patient Registration and Today’s Visit.

Established patients will only need to fill out Today’s Visit. Please let us know if your insurance or contact information has changed. 

You can fill out the forms when you arrive at the office if necessary.

Call to ask about wait time

and current availability

706.705.4543

Press option 1 to speak with our staff

New Patients Start Here

If you’ve never been a patient of a PrimeTime Clinic please start with our New Patient Registration Form.

If you prefer paper, you can download the Printable Registration Form.

Please also review our Privacy Practices, HIPAA Release, and our Financial Policy. For your convenience we can email you digital versions of these forms for signature prior to your visit.

 

Established Patients

If you have been a patient before please fill out the Online Today’s Visit Form.

If you prefer paper, you can download the Printable Today’s Visit Form.

Secure File Upload

If you need to send us copies of your insurance cards, drivers license, or any other documents please use this form.

Our Address:
1618 Mars Hill Rd Suite A,
Watkinsville, GA 30677

Off Mars Hill Rd in the Windridge Office Complex

Phone:
706-705-4543

Fax:
706-705-4635

Email:
info@primetimeurgentcare.com

Hours of Operation

Monday 7:30a-7:00p
Tuesday 7:30a-7:00p
Wednesday 7:30a-5:00p
Thursday 7:30a-7:00p
Friday 7:30a-7:00p
Saturday 7:30a-5:00p
Closed on Sundays

 

 

 

PrimeTime Urgent Care

Better Care Starts Here

Use the form below to contact us for general questions.
Please use the online registration  for secure communications.

Or call — (706) 705-4543