Planned Parenthood

Middle & East Tennessee

Medical Forms

New Patients: In order to save time when you get to our health center, please read the Notice of Health Information Privacy Practices and print and fill out our Medical Forms Package in advance of your appointment.

1. Notice of Health Information Privacy Practices. You do not need to print this document, you are only required to read it. You will be asked to sign a form in the Medical Forms Package acknowledging that you have read it.

2. Medical Forms Female or Medical Forms Male. Please print, fill-out as completely as possible, and bring with you to your appointment. Staff will review the forms with you during your appointment.

3. Credit Card Authorization Form. Fill out completely and bring with you to your appointment.

Already a Patient at PPMET and want a quicker way to refill your birth control pills, patches, or rings? Simple. Print off this "Mail Request for Birth Control" form, read carefully, fill out and mail to the PPMET Health Center nearest you or call with further questions. These are our locations:

412 Dr. DB Todd Jr Blvd.
Nashville, TNĀ  37203
710 N. Cherry St.
Knoxville, TN 37914
Johnson City
409 East Unaka Ave.
Johnson City, TN 37601
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Medical Forms