Feel free to download any of the following forms. Completed forms can be sent back to us by email address or fax.

Email: customerservice@pediatricsoffranklin.com
Fax: (615) 794-2883

New Patient Forms

For your convenience, new patient forms are available for immediate PDF download or online submission.

New Patient Registration Form

Patient Health History

Patient Developmental History

Online Patient Registration Forms

Medical Release Forms

To release medical records every doctor’s office needs written permission to do so. Please print your copy, sign your release and email or fax it back to us.

Specific Reason Release (Vaccination, Sports, Camp, Physical)

Send Old Records to Us Release

Request All Records from Us Release

Sports Physical Forms

Please be sure to download the correct form required by your specific school which may be found on from your child’s school website.

TSSAA Parent History Form (Required before doctor can sign form)

TSSAA Medical Form

Visit TSSAA.org for all physical forms and concussion information.

Attention Deficit/Hyperactivity Evaluation Forms

For children being evaluated for school or behavioral issues and have not been diagnosed with ADHD:

Parent Form (Child NOT on Medicine)

Teacher Form (Child NOT on Medicine)

For children who have already been diagnosed with ADHD and are currently being treated:

Follow Up Parent Form (Treating with Medicine)

Follow Up Teacher Form (Treating with Medicine)

Testimonials

"We are very pleased with PAF. Our boys have been patients here for almost 16 years."

- Anonymous

READ MORE

IS YOUR CHILD
SICK?

Visit our library to choose from over 100 symptoms and read more about managing your child’s illness. Our practice is focused on assisting families in the health and wellness of their children. We are available for consultation, prevention and treatment of the physical and emotional health concerns of infants, children, adolescents and young adults.

Acetaminophen & Ibuprofen Dosage Charts

Visit Symptoms & Illness Library