Martinez Urgent Care Inc.
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Office & Patient Forms

For your convince we have uploaded our patient forms to our website. You may complete these prior to your office visit. Please note there are several different forms, you only need to complete the form that is relevant to your reason for coming to the office.

Patient forms

release of medical records

new Patient DEMOGRAPHICS


employer/occupational forms

​workers comp COMPANY DEMOGRAPHICS

​​Occupational authorization form

Company & billing Demographics

WORKERS COMP EMPLOYEE DEMOGRAPHICS
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(706) 855-1755 | 210 Oak Street, Augusta, Georgia 
Mon. - Fri. 8am - 4pm
  • Home
  • Services
  • Insurance
  • Forms
  • About Us
  • Contact