Patient Forms

Forms are available to fill out when you come in for your appointment.

Mercy understands that sometimes financial circumstances make it difficult to pay for your visit at the time of service. If you are experiencing hardship, you may contact our Patient and Family Support Department at 615.790.0567. who will work with you to set up alternative payment arrangements.

View the Notice of Privacy Practices and Patient Rights (HIPAA)
(English | Spanish)

View our sliding scale here: (English | Spanish)

PATIENT PORTAL

QUICK LINKS

PATIENT PORTAL

LOCATIONS

Franklin Health Center

615.790.0567

Franklin Counseling Center

615.790.0567

Lewisburg Health Center

615.814.3400

MERCY DOCTORS ACCEPTS NEW PATIENTS FOR ALL SERVICES

Mercy Community Healthcare receives HHS funding and has Federal Public Health Service deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.

Cigna creates and publishes the Machine-Readable Files on behalf of Mercy Community Healthcare. Follow Quick Links on left column in footer.

Mercy complies with Title VI – Civil Rights Act.

This project is funded under a grant contract with the State of Tennessee.

Mercy Community Healthcare is insured by the Federal Tort Claims Act.

Fax: 615.595.8030