Welcome to Southern Medical Group
Fill out the new patient request form below, and we will contact you about setting up an appointment once we have reviewed your information.
Phone
Claxton Location: 912-739-3354
Glennville Location: 912-654-0475
Reidsville Location: 912-542-3050
Email:
NEW PATIENT APPLICATION FORM-
PLEASE FILL OUT THIS APPLICATION ONLY IF YOU ARE REQUESTING TO BECOME A NEW PATIENT OF SOUTHERN MEDICAL GROUP.
*See next section below labeled “New Patient Questionnaire” if your new patient request has already been approved and you need to submit information for your first appointment.
NEW PATIENT QUESTIONNAIRE-
PLEASE FILL OUT THE FOLLOWING QUESTIONNAIRE ONLY IF YOU HAVE ALREADY BEEN ACCEPTED AS A NEW PATIENT BY THE PRACTICE.