PATIENT INFORMATION and HISTORY FORMS
If you would like to fill out your Patient Information and/or History Information forms before your first visit, please select the correct form in the column on the left and double click to download a pdf version of the form.
You can then print the form, fill it out and bring it with you when you come for your appointment or you may fax your forms to us at 706.278.0580. If you would prefer to mail them, our address is Looper Speech & Hearing Center, 1011 Professional Blvd., Dalton, GA 30720.
If you are unsure as to which forms you will need you may give us a call at 706.226.4623 during regular office hours and we will be happy to help you.
OUR HOURS
Our office hours are Monday through Friday from 8:30 to 5:00.