Patient Forms

We provide the following forms as a convenience to our patients to print on their own, fill out at their own convenience, and bring with them to their appointment. Patients with questions about any of our forms are welcome to contact our office at (423) 573-9873. All documents are in the Adobe Reader PDF format.

Patient Forms

Patient Registration Form

Authorization for Release of Individually Identifiable Health Information

Authorization to Release Protected Health Information And Policy Acknowledgement

Controlled Substance Agreement