Office: 706-548-8697
Fax: 706-548-8698
info@athenspsychological.com

Office Hours
Monday - Friday: 9:00 - 6:00pm
Phone calls are accepted until 5:00 pm.

Which Provider would you like to see? *

Name of Insurance Company or Self-Pay *

Additional Information

Phone *

Insurance ID Card *

Are you looking for Medication Management, Therapy or Both? *

Medication Management

Therapy

Both

Patient Date of Birth *

Parent's Name (if patient is an adult enter "self") *

Please fill out the form below if you are interested in becoming a patient.

Email *

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Patient Name: *

New Patients

Do you have a secondary insurance? *

Yes

ATTENTION ALL NEW PATIENTS:

As outlined in the paperwork, our office policy for no show and cancellations (24 business hours) is a $75 fee. Missing an appointment because you did not receive a courtesy reminder does not relieve you of the fee.

​​​Please fill out the form below if you are interested in becoming a patient.

New Patients

Please fill out the form below if you are interested in becoming a patient.