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

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

New Patient Registration Form

Patient Health History – UNDER 3 MONTHS OLD

Patient Health History

Patient Health Questionnaire

Patient Developmental History

Online Patient Registration

Additional Forms If Required

Asthma Control Test

Screen for Childhood Anxiety Related Disorders

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

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

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)