Patient Registration Forms & Privacy Notices

If you are a new patient you may download, print and complete the registration forms below and bring them with you when you come for your appointment.

Registration Forms

Patient Registration

Forma de Registro Para Pacientes

Forma de Consentimiento del Paciente

Adult Health History

Pediatric Health History

Financial Agreement

Medical Records Release (as needed)

Autorizacion para el Suministro de Informacion

Privacy Notices

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Notice of Privacy Practices

Este aviso describe la forma en que puede utilizarse y revelarse la información sobre su salud y la manera en que usted puede tener acceso a esta información.

Aviso Sobre Las Practicas De Privacidad

These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here:

Get Acrobat Reader (this link opens a new browser window).

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HCA Physician Services, Brentwood, TN.