Patient Forms

If you’re a new patient with Haynes Neurosurgical Group, please complete the form in our new patient packet. For this, please follow the steps below:

1. Log into the patient portal using the login ID and password you would have received by email when your appointment was confirmed. 
2. Navigate to the Questionnaire section on the left, and complete the forms listed there.
3. All new patients must also fill out a medical release form. You can also complete it during your visit to our office.
4. Fill out the forms before you visit our office for your consultation so we can expedite the processing of all necessary paperwork.

Note: If you have not received your login information, please call us at (205) 787-8676. 

Haynes Neurosurgical Group Patient Packets

• Dr. Cezayirli New Patient Packet.pdf
• Dr. Johnson New Patient Packet.pdf
• Medical Release Form

Please use the forms below only if prompted by our office.

• ‍Patient Packet Information Sheet
• Medical Release for another facility or provider
• Patient Financial Responsibility
• ROS