PLEASE REQUEST YOUR IMMUNIZATION FORMS VIA THE PATIENT PORTAL FOR FASTER SERVICE.
INCLUDE YOUR CHILD'S NAME, DATE OF BIRTH AND THE FAX NUMBER FOR US TO SEND RECORDS. IF YOU WOULD LIKE US TO EMAIL TO YOU, PLEASE NOTE THAT WE WILL HAVE YOUR WRITTEN PERMISSION TO SEND VIA FAX TO AN UNSECURE EMAIL ADDRESS.
YOU MAY ALSO PICK UP YOUR FORMS AT ANY OF OUR OFFICES.
Gwinnett Pediatrics & Adolescent Medicine
Lawrenceville Office: 595 Hurricane Shoals Rd NW, Lawrenceville, GA 30046 | Phone: 404-355-0078
Duluth Office: 3790 Pleasant Hill Rd, Suite 230, Duluth, GA 30096 | Phone: 770-995-0823
Hamilton Mill Office: 2089 Teron Trace, Suite 100, Dacula, GA 30019 | Phone: 770-995-0823
Sugar Hill Office: 4700 Nelson Brogdon Blvd NE #180, Sugar Hill, GA 30518 | Phone: 770-995-0823
Important information for patients regarding COVID-19.
Coronavirus (COVID-19) information pageNow MENU
IMMUNIZATION FORM REQUEST
