Current Patient Follow Up Form

To save you time in the office and to ensure efficiency, please complete the following secure Patient Follow Up Form prior to your appointment. To be completed if you have not been by seen Dr. Singh in over 3 months OR were recently hospitalized.

If you would like to download and print this form, you may do so by clicking here and saving the PDF to your computer to print, complete, then scan or fax the form to our office.

IMPORTANT NOTE: This form is 256-bit encrypted to ensure your information remains safe at all times. If you have any concerns about the safety of using this webform, please contact our office.

ATLANTA HEART SPECIALISTS - REVIEW OF SYSTEMS (to be filled out if not done in the past 3 months)



PLEASE INDICATE BELOW. ARE YOU CURRENTLY EXPERIENCING ANY OF THESE SYMPTOMS:

General, constitutional

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Musculoskeletal

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Eyes and vision

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Skin and breasts

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Ears, nose, throat

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Neurological

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Genitourinary

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Psychiatric

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Respiratory

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Endocrine

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Gastrointestinal

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Hematologic/ Lymphatic

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Dr. Singh AHS – FOLLOW-UP VISIT PATIENT FORM(To be completed if you have not been seen in over 3 months or were recently hospitalized.)





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Echo(Cardiac Ultrasound)Stress TestNuclear Stress TestHeart Cath

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