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Online Forms

Dr. Don Lounsbury offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Notice of Privacy Practice

Download & Print Form


Automobile Accident Questionaire - Only needed  for personal injury appointments

Download & Print Form


Assignment of Benefits - Please sign and return

Download & Print Form



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Sign-Up Using the Form or Call Us at 615.883.9000 to Make Your Appointment Today!

Locations

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Office Hours

Our Regular Schedule

Monday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Tuesday:

9:00 am-1:00 pm

Wednesday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Thursday:

Closed

Friday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Saturday:

Closed

Sunday:

Closed