Office Hours:
Mon - Thurs: 8:00am - 5:00pm
Fridays: 8:00am - 2:00pm
Extended Hours:
Mon & Wed: 5:00pm-6.30pm
2713 Charles Hardy Pkwy, Ste. 223
Dallas, GA 30157

Phone: (678) 324-7021
Fax: (678) 401-3016

New Registrations

Welcome to CobbWest Internal Medicine. From this page you can pre-register or you may utilize the attached forms to complete registration. You may fill the forms prior to your visit to shorten the intake process. Also find are other forms we encourage you to read carefully.

On-line Registration

Please select this link to the Web Portal and utilize the Pre-Registration link. Our office will contact you promptly to schedule your appointment.

Paper Registration

Please utilize the forms below for the registration process. Please bring them with you for your first visit.

Please printout and complete the following forms:


Note: The above documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here.

Alternatively, you may call us at 678-324-7021 and our staff are happy to assist.
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