John Harrell, DMD
3400-A Old Milton Parkway, Suite 460
Alpharetta, GA 30005

Patient Information

Our first concern is our patients. This page has general information and forms; we are here to help!

First Visit
Below are the forms that a first time patient should fill out prior to their first appointment.

To schedule an appointment, please call 770-410-7565.

We try to adhere to the appointment schedule, but emergencies can cause delays.

If you must cancel an appointment, we request that you give us 48-hour notice.

Privacy Policy
The Notice of Privacy Practices presents the information that federal law requires us to provide to our patients regarding our privacy practices.

Please read the notice and then fill out the Health Information Consent form.

This notice consent form is a pdf document which requires Adobe Acrobat Reader software. Most computers will already have this software loaded. If you have problems reading the notice, please download and install the Adobe Acrobat Reader software.

Financial Policy / Insurance / Care Credit
We share your concern about the increasing costs of providing health care. Our fees are usual and customary for this area.

A major cause of increased health care costs is the expense of preparing statements, mailing and bookkeeping. In order to keep costs as low as possible, payment is expected at the time services are rendered unless other arrangements have been made. Please be aware that you may be responsible for a "co-pay", deductible or other portion of the bill, depending on your insurance.

Should you have special financial needs, please contact our office manager. We will make every attempt to make acceptable financial arrangements.

3400-A Old Milton Parkway, Suite 460 • Alpharetta, GA 30005 • (770)410-7565


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