New / Returning Patient Forms
All NEW and RETURNING patients must read the following important information and fill out the required forms listed below BEFORE arriving at the scheduled appointment time. Not doing so will delay the appointment and it may need to be postponed. If you have trouble receiving the paperwork, please let us know before the appointment and we can mail it to you.
The fillable PDF forms, must be downloaded with Adobe Acrobat Reader before being filled out. (See the link to the right). They can then be emailed to [email protected]. They can also be printed and mailed or faxed to our office before your appointment. Our fax # is (901) 763-4794. We would prefer to receive the paperwork before your appointment; however, if you choose to bring them to you appointment, please fill them out before you come to the office.
- New / Returning Patient Information
- Patient Registration Form
- Medical History Form
- Additional Medications & Medical Information Form
- HIPAA Acknowledgement Form
- HIPAA Privacy Rules
* These forms can be mailed if you do not have access to email or a fax#.
What To Expect
Your first visit to our office involves a few special steps so that we can get to know you. Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on our site. You'll also find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. Please take some time to review our staff page and familiarize yourself with the doctor. We look forward to your first visit.