During this time of online appointments, please be advised that all paperwork for new appointments must be completed and sent back via email or fax. Should we not receive the paperwork back within 24 hours of the appointment time, your appointment will be cancelled.
New Patient Paperwork should be emailed to firstname.lastname@example.org or faxed to 865-313-2149
Medication Management Forms
Please complete the printable forms below and bring with you to your first appointment. If you are unable to print the forms then please arrive at least 30 minutes early so that you can complete the forms in the office. The forms must be complete before you can be seen. If you are seeing a therapist you will complete one packet if you are seeing a nurse practitioner then you will need to complete the additional packet for the nurse practitioner.
PLEASE BE ADVISED THAT PAPERWORK THAT IS NOT COMPLETED AT THE TIME OF YOUR APPOINTMENT WITH THE NURSE PRACTITIONER WILL RESULT IN THE CANCELLATION OF YOUR APPOINTMENT.
ALSO BE ADVISED THAT CHILDREN UNDER THE AGE OF 16 BEING SEEN FOR A FIRST TIME MEDICATION APPOINTMENT WITH A NURSE PRACTITIONER MUST BE ACCOMPANIED BY A LEGAL GUARDIAN. IF THE LEGAL GUARDIAN IS NOT PRESENT FOR THE FIRST APPOINTMENT, THE APPOINTMENT WILL BE CANCELLED.
For best results, please open these forms in Chrome or Firefox.
NOTE: These forms are designed as fillable PDF documents for convenience if desired. Currently our electronic records system does not allow for digital signatures so they must be printed out and signed by hand.