Executive Wellness Patient Information 

Thank you for choosing Executive Wellness at Georgia Regents Health System for your comprehensive medical care. We ask that you please fill out this Health Information Form prior to your appointment. Our Executive Wellness Team will then be able to process your health history information effectively and efficiently to provide the highest quality of care. All patient information provided through the Health Information Form is processed through secure servers and will retain complete patient confidentiality.

If you have already starting filling out the Health Information Form, simply continue here to complete the form prior to your appointment. 

If you have any questions about filling out the Patient Information Form, please call our Executive Wellness Navigator at 706-723-4478 or e-mail, execwellness@gru.edu.