New Patient Forms
If you are new to Kirk Health Clinic, welcome! We are glad you have chosen us. To help make your first visit even quicker and smoother, you can now download, print and complete your new patient paperwork from the comfort of your own home.
If you have any questions about these forms, or to talk to us about your next appointment, call us today at 423-585-5556 or contact us by using our convenient Online form.
Medical History and Confidentiality Form
For patients returning to the office, if it has been more than 3 years, or if you have had any recent medical changes we should be aware of, please complete the new medical form below prior to your next appointment.
Health Information Release Form
The privacy of your health information is important to us. Please complete this form to choose how we may share your health information with you and/or others.
Acupuncture Registration Form
If you're a new patient, please complete our Acupuncture Registration Form prior to your first appointment.
Auto Accident Injury Form
COMPLETE THIS FORM ONLY IF you are seeking treatment for an auto accident injury a third party is financially responsible for. For example, an insurance company, employer or attorney.
CONTACT US
Monday: 8:00AM - 6:00PM
Tuesday - CLOSED
Wednesday - 8:00 AM - 6:00 PM
Thursday - 8:00 AM - 6:00 PM
Friday: 8:00AM - 6:00PM
Saturday - 9:00 AM - 11:00 AM
Sunday - CLOSED
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