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.

A Natural Way to Better Health 423-585-5556

CONTACT US

1539 W. Andrew Johnson Hwy

Morristown, TN 37814

Tel: 423-585-5556

Monday-Thursday: 8:00 - 6:00 PM

Friday: 8:00-1:00 PM

QUICK LINKS

TREATMENTS

© 2017 Kirk Health Clinic P.C. All Rights Reserved. Privacy Policy | Designed By:

RH INC Design Studio

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.

A Natural Way to Better Health 423-585-5556

CONTACT US

1539 W. Andrew Johnson Hwy

Morristown, TN 37814

Tel: 423-585-5556

Monday-Thursday: 8:00 - 6:00 PM

Friday: 8:00-1:00 PM

QUICK LINKS

TREATMENTS

© 2017 Kirk Health Clinic P.C. All Rights Reserved. Privacy Policy | Designed By:

RH INC Design Studio

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 the 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.

A Natural Way to Better Health423-585-5556

TREATMENTS

CONTACT US

1539 W. Andrew Johnson Hwy

Morristown, TN 37814

Tel: 423-585-5556

Monday-Thursday:

8:00 - 6:00 PM

 

Friday: 8:00-1:00 PM

QUICK LINKS

© 2017 Kirk Health Clinic P.C. All Rights Reserved. | Designed By:

RH INC Design Studio