Forms

We Are Glad To Be Your Healthcare Provider.

Avoid spending extra time in the waiting room filling out paperwork.

Complete your forms at the link below now. Then submit them by mail, fax, or when you arrive for your appointment.

Welcome & Information Packet

Registration and Consent

Telehealth Consent Form

Patient Registration Form

Release of Medical Records

Consent to Treat A Minor

Now Introducing Online School Health Registration!

Select the correct school below, fill in all required fields, sign, and submit.

Registration forms are then sent directly to our staff.

WISD School Health and Dental Registration Form

WISD School Health and Dental Information Packet

Whitley County Dental Registration Form

Whitley County Dental Information Packet

Jellico School
Health Registration Form

Jellico School
Health Information Packet