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)