My Health Records

 

Patient Forms

Download the forms above, fill out (using Acrobat Reader) then print. OR You can click to downloadprint and fill out manually (Black or Blue Pen).

 

Request an Appointment

Please fill out the below form and we will be in touch with you soon.  Or give us a call at 731-427-9971 to schedule an appointment.

Are you a new patient? *
Name *
Name
Date of Birth *
Date of Birth
Address *
Address
Phone *
Phone
Alternate Phone
Alternate Phone
Appointment Date Preference
Appointment Date Preference
Appointment Time Preference *
Primary Policyholder’s DOB *
Primary Policyholder’s DOB
Primary insurance claims mailing address
Primary insurance claims mailing address
 

Contact Information

28 Medical Center Dr
Jackson, TN 38301
Phone: (731) 427-9971

Business Hours

Monday  8am - 5pm
Tuesday  8am - 5pm
Wednesday  8am - 5pm
Thursday  8am - 5pm
Friday  8am - 5pm

Our Providers

E. Scott Yarbro, M.D.
Don McKnight, M.D.
Raymond C. Howard, M.D.
John Carraher, M.D.
Peter G. Lawrence, M.D.
Kelly Johnston, PA