Patient Forms – Naaman Clinic

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DISCLOSURE AUTHORIZATION

AUTHORIZATION TO DISCLOSE HEALTH INFO (FOR CANCER POLICIES)

Locations

Gadsden
100 Medical Center Drive, Suite 101
Gadsden, AL 35903
Birmingham
100 Concourse Parkway, Suite 265
Birmingham, AL 35244
Montgomery
1722 Pine Street, Suite 400
Montgomery, AL 36106
Sylacauga
11 North Norton Ave
Sylacauga, AL 35150

Scheduling

T: 205.453.4195
F: 205.533.7385
Hours: Monday - Friday 8am through 5pm
For billing call: 205.721.9705

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**DISCLAIMER Claims of results, patient testimonials, treatment recovery time, and before/after images may not be representative for every situation or be applicable to every patient. Individual results may var. Always seek the advice of a physician or other qualified health care provider with any questions you may have regarding a medical condition, treatment, or elective procedure.