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 carefully choose only the forms listed under the office and/or physician, as indicated, where and/or with whom 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.

 Neck pain questionnaire  (for Dr. Law’s patients ONLY) 
 Consent to treat form (for unaccompanied minors) 

HARDING PLACE CARE CENTER
 Registration form 2012
 Medical history intake form 2012 
 Consent to treat form (for unaccompanied minors)

HENDERSONVILLE CARE CENTER

 Registration form
Medical history form

MRI CENTER
 Registration form

MURFREESBORO CARE CENTER

 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

 Registration form
Medical history form

SUMMIT CARE CENTER

 Registration form (for ALL Summit physicians' patients)
 Medical history form (for patients of Dr. Reid, Dr. Pierce, Dr. Kaminsky & Dr. Dimick ONLY )

 Medical history form (ONLY for Dr. Novak & Dr. Eby's patients)
 Pain history form (for Dr. Dimick'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.