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Registration Forms

For Patients:

The following forms have to be filled out accurately for every new patient and established patients who have not been seen in over one year. Filling out these forms prior to your appointment can expedite your appointment process and cut down on errors.

Once you have completed your forms, please print them, sign them and bring them to your appointment.

Patient Registration Packet

Minor Patient Registration Packet

Notice of Privacy


Referral/Consult Request

To request a referral or a consultation, please fill out the appropriate form and fax to (423) 778-4901 or call (423) 778-4900.

Outpatient Referral Form

Inpatient Consult Request