1370 Wellbrook Circle Conyers, GA 30012  |  4181 Hospital Drive, Suite 102, Covington, GA 30014 |  1110 Commerce Drive Suite 108 Greensboro, GA 30642

770-922-5458  |  770-385-0321

You can make your appointment online at https://www.piedmont.org/.

We ask all New Patients to create your account through our Patient Portal and complete patient information and medical history online.

We are a provider of most major insurance carriers. We do advise all patients to check with their insurance company to make certain that our doctors are participating providers.

If your insurance company requires you to have a referral prior to seeing our doctors, it is your responsibility to obtain this referral prior to your visit.

If you are having a recurrent problem and have made an appointment with our office, we request that you bring all pertinent records with you for the past six months to a year along with medications that you have been taking for this problem. Also any ct/mri films for recurrent sinusitis (actual discs with report).

Patient Forms

Please log on to the Patient Portal to complete this information:

NOTE* If you have trouble accessing our portal to complete information please call our office (770) 922-5458.

  • Patient Information Form
  • Patient History Form

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.


1370 Wellbrook Circle
Conyers, GA 30012