Forms
Policies PoliciesPlease PRINT and complete the forms listed below. Bring the completed forms, insurance cards, and ID with you to your first visit in our office.
Please PRINT and complete the health history form. Please list or bring a list of all mediactions you are currently taking. Adult health history form is recommended for anyone over the age of 6.
Health History- Adult*Our office requires an updated medical history to be completed every two years.
Privacy Policy does not have to be printed off for your visit. A copy of the policy below is so you are aware of the policy and can print a copy for your records if you would like.
*If you would like to email the completed forms to us, please send them to This e-mail address is being protected from spambots. You need JavaScript enabled to view it with the subject as New Patient Forms.
*If you would like to fax the completed forms to us, please send them to 423-478-3567 with Cover Page Attn: New Patient Forms.
***NEW ADDRESS: 413 Berywood Trail NW, Cleveland, TN 37312
