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EMORY CLINIC PATIENT QUESTIONNAIRENAME ADDRESSCLINIC PHYSICIAN Instructions: Please answer all questions to the best of your ability. Check all questions asking yes or no answers appropriately, but
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Make sure to gather all the necessary documents such as identification, insurance information and medical history before visiting Emory Clinic.
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Arrive at the clinic a few minutes before your scheduled appointment time.
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Check in at the front desk and provide your personal information as requested.
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Fill out any required forms or questionnaires accurately and completely.
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Be prepared to answer questions about your symptoms and medical history during your appointment.
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Once your appointment is complete, make sure to schedule any recommended follow-up appointments or tests.

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Emory Clinic is a healthcare facility affiliated with Emory University in Atlanta, Georgia.
Healthcare providers and facilities affiliated with Emory University are required to file Emory Clinic.
Emory Clinic can be filled out online or through paper forms provided by Emory University.
The purpose of Emory Clinic is to report healthcare services provided by affiliated providers and facilities.
Information such as patient demographics, services provided, and billing codes must be reported on Emory Clinic.
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