Dr. Susan Barnes, West Knoxville, TN
Dr. Susan Barnes, West Knoxville, TN
 
   

formIf you would like to complete your registration forms before you arrive, you may download them by clicking below. The Health History form is in PDF format. If you do not have Acrobat Reader, get a free copy by clicking on the link below. Also, after reading the Notice of Privacy Practices, print the Acknowledgement form below, sign it, and bring it in, too.

 

Welcome Letter (web page)

Adobe PDFAcknowledgement of Receipt of Notice of Privacy Practices

Adobe PDFPatient Registration Form

Adobe PDFAdobe ReaderMedical History

Adobe PDFRecords Request Form

Adobe PDFRecords Release Form

Adobe PDFRequest for Limitations & Restrictions of Protected Health Information

X-ray release form (web page)

Adobe PDFNondiscrimination Notice