The download below contains patient registration forms and other documents relating to your visit.
To ensure an efficient and enjoyable experience for all of our patients, we ask that you follow a few simple guidelines during your visit.
Walk-in patients are welcomed daily,however, this availability is subject to change depending on the number of walk-ins that have already been accepted during this time. For all other visits, please make an appointment in advance by calling 662 754-3301 or sending us a message.
First-time visitors are required to fill out the new patient registration form, health questionare, are privacy form which can be downloaded and printed out in advance using the download link below.
Thank you for your cooperation!
Note: You will need Adobe(r) Reader(r) to view PDF files. If you do not have it, you can download it for free.
SHAW FAMILY MEDICAL &
A Brand New Me Wellness Center
112 W Peeler Ave
Shaw, MS 38773
Phone: (662) 754-3301
GOUGH'S FAMILY MEDICAL CLINIC
189 N Main Street
Drew, MS 38737
Shaw Family Medical
Mon - Fri
Gough's Family Medical Clinic
Mon, Tues, Thur
7 Days Per Week
8:00AM until 12:00 Midnight
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