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Submit the form below. Or call (615) 805-5537 for assistance in filling out the form. We will reach out and contact you at the latest, the morning before your intake appointment

*Testing Kit fee(1-2 Urine Drug Test, Pregnancy Test (if Applicable), Cell Phone Stand, Shipping/Handling costs unless alternate testing arrangements made with Clinic Staff. Payment does not guarantee a prescription, a patient must meet standards, criteria, and eligibility as determined by the provider.
Click Here for HIPAA Privacy Policy — The HIPAA Privacy Rule mandates that health care providers distribute a Notice of Privacy Practices to all patients. This document outlines how protected health information about an individual may be used and disclosed and under what circumstances specific authorization from the individual may not be required. The Notice of Privacy Practices also describes the HIPAA defined patient rights related to use and disclosure of the individual’s health information.
