Mon-Thur 8am-6pm | Fri 8am-4pm | Closed Sat-Sun865-212-6600

Mon-Thur 8am-6pm | Fri 8am-4pm | Closed Sat-Sun

865-212-6600

Mon-Thur 8am-6pm

Fri 8am-4pm

Closed Sat-Sun

865-212-6600

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.

Adult – New Client Packet

New Patient Form

If you are seeing a nurse practitioner, please complete this additional pack:

Nurse Practitioner Form – Adult – Chenoa
Nurse Practitioner Form – Adult – Sara
Nurse Practitioner Form – Adult – Kate

Child – New Client Packet

New Patient Form

If you are seeing a nurse practitioner, please complete this additional pack:

Nurse Practitioner Form – Child