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In order to better serve you, we have several forms available for you to download and fill out in advance of your appointment. Please bring your completed forms with you to your appointment.
Forms are listed by Care Center. Please choose only the forms listed under the office where you have an appointment! (Please note that Centennial Care Center physician, Dr. Melvin Law, has additional forms that should be completed.)
In addition to Care Center-specific forms, all patients are asked to read our Privacy Policy. Patients should then download and print the Privacy Practices Acknowledgment form. Please bring completed forms to your first office visit. Thank you.
CENTENNIAL CARE CENTER
 Patient registration form
Medical history form (NOT for Dr. Law’s patients)
Back pain questionnaire (for Dr. Law’s patients ONLY)
Neck pain questionnaire (for Dr. Law’s patients ONLY)
Consent to treat form (for unaccompanied minors)
HARDING PLACE CARE CENTER
Patient registration form
Medical history form
Consent to treat form (for unaccompanied minors)
HENDERSONVILLE CARE CENTER
Patient registration form
Medical history form
MRI CENTER
Patient registration form
MURFREESBORO CARE CENTER
Patient registration form
Medical history form
SKYLINE CARE CENTER
New patient registration form
(also for patients returning with a new problem, or who have not been seen in over one year)
Medical history form
Consent to treat form (for unaccompanied minors)
STONECREST CARE CENTER
Patient registration form
Medical history form
SUMMIT CARE CENTER
Patient registration form (for ALL Summit physician patients)
Medical history form (for ALL Summit physician patients, EXCEPT Dr. Novak's)
Medical history form (for Dr. Novak's patients ONLY)
Pain history form (for Dr. Dimick and Dr. Ebys' patients ONLY)
Consent to treat form (for unaccompanied minors)
PRIVACY POLICY (HIPAA)
New patients are asked to read our Notice of Privacy Practices. After reading the Notice of Privacy Practices, new patients should download the Privacy Practices Acknowledgement form to complete and then take to their first visit.
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