Online Forms

Practice Member Intake Information:

Before your first visit please print and fill out the following Practice Member Intake Form by clicking the link below the appropriate age form.  If able to e-mail them back to us prior to your appointment that would be great.  Thank you! 

If you have any issues or questions regarding these forms please call out office for assistance 912-826-3482


Adult History (13 and up)

adult-hx-new-2023.pdf 

Pregnancy History

pregnancy-hx-new-2023.pdf

Infant History (0 to 4 years old)

infant-hx-new-2023.pdf

School Aged History (5 to 12 year old)

school-aged-hx-new-2023.pdf 

CONTACT US TODAY

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Office Hours

CLOSED: Nov. 23, 2022 through Nov. 27, 2022 for Thanksgiving! Happy Holiday's!!

Empowered Life, PC

Monday:

9:30 am-1:00 pm

3:00 pm-6:00 pm

Tuesday:

9:30 am-1:00 pm

3:00 pm-5:00 pm

Wednesday:

9:30 am-1:00 pm

3:00 pm-6:00 pm

Thursday:

Closed

Friday:

9:30 am-1:00 pm

3:00 pm-5:00 pm

Saturday:

Closed

Sunday:

Closed