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TO MAKE AN APPOINTMENT
MAIN OFFICE / EAST BRAINERD OFFICE / CLEVELAND OFFICE

(423) 267-6738

TO MAKE AN APPOINTMENT
MAIN OFFICE / EAST BRAINERD OFFICE / CLEVELAND OFFICE

(423) 267-6738

  • HOME
  • WHO WE ARE
    • Our Practice
      • Employment Opportunities
    • Our Physicians
    • Mission Statement
    • Vision Statement
    • History of Our Practice
  • SERVICES
    • About Otolaryngology
    • Medical Services
    • Audiology/Hearing Services
      • What is an Audiologist?
      • Evaluations
      • Hearing Loss
      • Hearing Aids & Products
      • Contact Us
    • Sinus Allergies
      • Shot Schedules
    • Botox
    • Sleep Apnea
    • Dizziness
    • Pediatrics
    • Head and Neck Cancer
  • LOCATIONS
    • Our Cleveland Office
    • East Brainerd Office
    • Hixson Office
    • Hospital Affiliations
  • STAFF
    • Audiology
    • Allergy
    • Administration
    • Clinical
    • Careers
  • FOR PATIENTS
    • Billing and Insurance
    • Cancel Appointments
    • Financial Policy
    • First appointments/Registration
    • FMLA and Disability Requests
    • HIPPA Information
    • Lab and Test Results
    • Locations
    • Medical Records and Test Results
    • Notice of Privacy
    • Patient Forms
    • Post-Operative Instructions
    • Pre-Operative Care
    • Prescription Refills
    • Weather Emergency
  • FOR PHYSICIANS
    • Referring a Patient
    • Physician Recruitment

Patient Forms

Click Below to Download


Audio Services Pre-Test


Authorization for disclosure of protected health information


Insurance Instructions Regarding Surgery


Permission to Release Information


Request / Release for Information


Surgery Insurance Assignment

For Patients

Billing and Insurance

Cancel Appointment

Financial Policy

First Appointment/Registration

FMLA and Disability Requests

HIPAA Information

Lab Test and Results

Locations

Medical Records and Test Results

Notice of Privacy

Patient Forms

Patient Registration

Post-Operative Instructions

Pre-Operative Instructions

Prescription Refills

Weather Emergency

Downloads

Insurance Instructions Regarding Surgery

Authorization for disclosure of protected health information

Request / Release for Information

Permission to Release Information

Audio Services Pre-Test

Surgery Insurance Assignment

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1724 Hamill Road, Suite 102 · Hixson, TN 37343 · 423.267.6738

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