Patients

List the name and date of birth for each child in your family who is a patient.

 

Patient Portal Access


Access to records is available for all children under 18 years of age. When a patient turns 18 years old in the State of Tennessee, by law, their record automatically becomes private. They may grant permission to a parent or guardian to access their chart by signing an additional release form.

Please list the name and email of the parent/guardian that would like access to the patient portal.
 Parent/Guardian Name
 
 
 
 
 Parent/Guardian Name