Get the free New Patient Forms - Tennessee River Dermatology

TENNESSEE RIVER DERMATOLOGY 2471 Elton Drive Florence, AL 35630 256.765.2000 www.tennriverderm.com Thank you for choosing Tennessee River Dermatology. Enclosed please find the required forms for our

How to fill out new patient forms

Point by point instructions on how to fill out new patient forms:

1. Start by carefully reading through each section of the form. Take note of any specific instructions or information that is required.
2. Begin by filling out the personal information section. This typically includes your full name, address, phone number, and date of birth.
3. Move on to the medical history section. Provide accurate and detailed information about any pre-existing medical conditions, allergies, medications you are currently taking, and any previous surgeries or hospitalizations.
4. If there is a section for family medical history, provide information about any hereditary conditions or diseases that run in your family.
5. Next, fill out the insurance information section. If you have health insurance, provide your policy number, group number, and the name of your insurance provider. If you do not have insurance, leave this section blank or indicate that you are a self-pay patient.
6. If there is a section for emergency contacts, provide the names and phone numbers of one or two people who can be reached in case of an emergency.
7. Lastly, make sure to sign and date the form where required. This acknowledges that all the information provided is accurate and complete.
8. New patient forms are typically required for anyone seeking medical treatment or services at a healthcare facility for the first time. This includes individuals who have recently moved to a new area and are establishing care with a new healthcare provider, as well as those who are visiting a specific medical specialist for the first time.
9. Even if you have been a patient at a particular healthcare facility before, you might still be required to fill out new patient forms if it has been a significant amount of time since your last visit or if there have been any changes to your personal information or medical history. This is done to ensure that the healthcare providers have the most up-to-date and accurate information to better assist you.

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