Patient Forms
Please download and complete the appropriate forms before your appointment to help save time at check-in. Click a form to open or download it - your device will handle the PDF using its built-in viewer.
If you have questions about which forms to bring, please call our office at (865) 637-8635.
New Patient
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New Patient Referral Form PDF
Complete this form if you are being referred to our practice for the first time. Your referring physician may also submit it on your behalf.
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General Consent for Care PDF
Authorizes our practice to provide medical evaluation and treatment. All patients are asked to complete this form.
Medical History
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Past Medical History PDF
Covers prior diagnoses, surgeries, hospitalizations, and family medical background. Completing this before your visit helps our team prepare.
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Medication List PDF
List all current medications including prescriptions, over-the-counter drugs, vitamins, and supplements. Include dosages where known.
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Physician Care Team PDF
Provide the names and contact information for your primary care physician and any other specialists currently involved in your care.
Privacy & Authorizations
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HIPAA Form PDF
Acknowledges your receipt of our Notice of Privacy Practices, which describes how your health information is used and protected.
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Message Consent PDF
Authorizes our office to contact you by phone, voicemail, or electronic message for appointment reminders and care-related communications.
Additional Forms
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Supplemental Intake Form PDF
Covers advance directives (living will and power of attorney), vaccine history, and tobacco use.
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Patient Portal Form PDF
Sign up for the MyChart patient portal to view your health records, lab results, and appointment information online.