If you are a resident of East TN, you can apply for help right here on our site.
To get started on your search for help, we will first need you to download all of the forms found below. Once you have completed them, you will need to return them, along with a copy of a valid government issued ID. The contact information for returning these forms can also be found below.
Application for Assistance
Authorization for The Use of Image
Medical History Form
Patient Information Form
HIPAA Authorization Form
Contact us: Click to E-mail
Deliver in person or via mail to: 313 North Forest Park Boulevard, Knoxville, TN 37919
Fax forms to: 865-253-7990