Download Forms

On this page you will find all of the forms you need to make your enrollment or visit to the emc2care offices fast and efficient.  All of the forms are in PDF format which can easily be downloaded and printed on your own printer.  You will need Adobe Acrobat to view these documents.  If you need Adobe Acrobat Reader, you may CLICK HERE to download and install on your system.

If you are preparing for you first Risk Assessment Visit please make sure you have downloaded and filled out all of the forms listed in that section so that we can spend the total time of your visit on your care and not your paperwork.

Patient Information Form     Download PDF

As part of your enrollment you must complete a new Patient Information Form.  Please download and complete the form and bring to your appointment.

Comprehensive Risk Assessment Patient History Form     Download PDF

Before your Comprehensive Risk Assessment, please download and complete this form.  Please bring your original forms with your visit.

Payment Authorization Form     Download PDF

To setup monthly payments for your emc2care membership, please download and fill out the form completely.  You may send by mail or fax to 678.513.1147.

Membership Enrollment Agreement     Download PDF

To fully enroll as a member of emc2care you must complete the Membership Enrollment Agreement. Please print all pages and fill out completely. Please Mail the original copy to the address on the agreement. If you wish to fax the agreement please fax to 678.513.1147

enroll today

Begin your pre-enrollment process with North Atlanta’s exclusive membership care program, and enjoy exciting Membership Benefits

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meet our team

Meet the emc2care team and see what makes our exclusive membership program truly unique.

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team contacts

Alan D. Einstein D.O. 678.513.2228

Teresa Slagle, 678.513.4722

Fairoz Radke PA-C 678.513.4722

Fax 678.513.1147