Forms

We are pleased that you have chosen Birmingham Internal Medicine Associates, P.C., (BIMA) to be your Primary Care Providers. In order to streamline you initial visit, we ask that you arrive 30 minutes prior to your appointment. You will be given a computer tablet at the time of your visit to electronically enter all of your other required patient information.

Please be sure to bring a valid photo ID, insurance card, and credit card to cover any required deductible payments. We look forward to seeing you at your appointment.

Existing Patients - If any of your information has changed, including phone numbers, addresses, work information, or insurance, or if it has been ONE year since your last update, you will be asked to update this information on the provided computer tablet at the time of your visit. Please arrive at least 20 minutes prior to your appointment to complete this updated information.

Please Note - Our only online form is our Medical Records Request form which can be completed and faxed to (205) 930-2063 for copies of your medical records. There is a fee associated with printing and duplication of your medical records. This form is in the PDF format and a compatible PDF reader may be downloaded at http://get.adobe.com/reader.

New & Established Patient Medical Records Request Form
If you have any questions regarding the entering of your information electronically, you may ask the front office receptionist to assist you when you arrive for your appointment.

Birmingham Internal Medicine Patient Satisfaction Survery