Martha J. Little, M.D., D.Ph.

Welcome


** Effective July 1, 2019 **




Record Transfer Requests:



1) Please click on the "Forms" link.  
2.) Print the "Release of Information from the Office of Dr. Martha Little" form.  
3.) Fill out the top lines with the new 
physician's contact information -
  
(please include mailing address and a secure fax 
number for new provider).
4.) Check as many of the boxes in the middle as necessary for your purposes.
5.) Sign and date at the bottom.
 6) Must have a witness signature

7.) Mail to PO Box below.


Records will be sent to new physician's office in the order they are received.   Forms received without all information listed above will not be sent, so please be sure all steps are followed.

 



PO BOX 1063
Alpharetta, GA 30009-1063

email: office@mjLITTLEmd.com