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

Welcome


** Effective November 1, 2018 **




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 -
  
(must include a secure fax 
number for new provider).
4.) Check the boxes in the middle.
5.) Sign and date at the bottom. 
6.) Return to our office.


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

 



814 Mimosa Blvd.
Building C
Roswell, GA 30075

Office: (770) 772-0909
Fax: (770) 442-1542

email: office@mjLITTLEmd.com