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 the completed form 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 (Dr. Law’s patients only)
  Neck pain questionnaire (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
  Medical history form
  Pain history form (Dr. Dimick and Dr. Eby’s
        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.