Patient Resource Center

Schedule an Appointment
Contact us via email, and a member of our staff will return your call shortly to set up an appointment. Be sure to include your full name and phone number, and let us know if you are a new or returning patient.
Patient Privacy Policy (HIPAA Patient Consent Form)
Our notice of privacy practices provides information about how we may use and disclose protected health information about you. Please download the HIPAA Notice prior to your appointment, read it over carefully and bring it in with you.
Patient Forms
For your convenience, we have supplied forms that can be filled on line. Click on the links below, complete the information and click the submit button. We will have them all ready for you when you make your first visit! We look forward to greeting you!

» HIPAA Authorization
» History and Intake Form
» New Patient Registration
» Financial Policy
» HIPAA Notice (pdf)
(865) 474-8800
Cosmetic Dermatologist KnoxvilleDirections
Request an Appointment
Submit your appointment request directly from our site.
Patient Resource Center
Prior to your appointment please fill in the below online forms and submit, to save yourself time in the office.