New Patient Paperwork

Active Healthcare and Rehabilitation, PC offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.
  • Patient Intake Form

    Click to Download

OFFICE HOURS


Monday
9:00am - 1:00pm
3:00pm - 7:00pm


Tuesday
3:00pm - 7:00pm


Wednesday
9:00am - 1:00pm
3:00pm - 7:00pm


Thursday
9:00am - 1:00pm
3:00pm - 7:00pm


Friday
9:00am - 1:00pm


Saturday
9:00am - 1:00pm


Sunday
Closed

Active Healthcare and Rehabilitation, PC

1250 B Auburn Rd, Suite 201A
Dacula, GA 30019
P: (678) 689-6888
F: (678) 689-6881