Patient Forms

If you would like to request an appointment with Primary Care Specialists, please contact us at 901-458-0162. Primary Care Specialists wants to make your visit quick and easy by providing you with some of the necessary office forms ahead of time.

Please complete these registration forms and bring them with you to your appointment. Failure to bring them with you may result in appointment delays. New patients, please arrive 20 minutes prior to your scheduled appointment and remember to bring your insurance cards and photo I.D. or Driver’s License.

Your Registration Packet includes:
Patient Demographics (Information) Form
Medical History Form
Notice of Privacy Practices

Please remember to bring the following items with you to your doctor’s appointment:
Your completed registration paperwork
Your insurance card(s) and photo I.D. (i.e. Driver’s License)
All medicines and vitamin supplements you are taking because the provider will be reviewing these at your visit
Your co-payment - due in full at time of service

Need to update your patient information?
Please inform us of any changes to your contact information. We need your help in maintaining your patient records so that the doctors and nurses can reach you with important health information.  Fax an updated Patient Demograhics (Information) Form to 901-458-0388 or email us.