Patient Information Update - This form is for our CURRENT patients who have changes to their address, phone number, insurance information, Consent, etc...  You can print it out, complete the required information and either mail, fax or bring it to our office.  Our fax number is (865) 577-6475.

Request for Electronic Copy of Protected Health Information (PHI) - This form is for our CURRENT patients who are requesting healthcare information be sent to them via email.  You may print out the form, complete the required information and either mail, fax or bring it to our office.  Our fax number is (865) 577-6475.

Request to Send Protected Health Information (PHI) to a Third Party - This form is for our CURRENT patients who are requesting healthcare information be sent to a third party.  You may print out the form, complete the required information and either mail, fax or bring it to our office.  Our fax number is (865) 577-6475.

HIPAA Privacy Notice - Kids Choice Pediatrics' Privacy Policy.

No Surprises Act 2022