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LIFETEST of Atlanta
1140 Hammond Drive, Suite 9120, I Building
Atlanta, GA 30328
1-888-730-0119
770.730.0119   FAX: 770.730.0114
Atlanta@Lifetest.com
Directions / Map
Facility Map

Patient Forms
You may download the appropriate forms below to review and/or fill out to save time upon your arrival at LIFETEST:

HIPAA Acknowledgement
Medical Release Form
Medicare - Release of Responsibility
Notice of Provider Practices
Patient Information
Patient Medical History
Patient Consent

 
Request Appointment/Additional Information
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Address:
City:
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Zip Code:
Telephone:
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Please send me special offers from LIFETEST
Please sign me up for the LIFETEST newsletter
Yes, I would like to have someone contact me to schedule my LIFETEST Scan and I will receive the results on CD-ROM for FREE! (A $20 value)

Please select the screening test(s) you are interested in:
Heart / Coronary Artery Abdomen/Pelvis
Lung Full Body
Heart/Lung

Special Instructions/Comments:

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