innovation in targeting cancer

Forms and Policies

New Patients, please download and complete the following forms before your first visit.
You can email, fax or mail the forms to Susan Eby before your first appointment. Please complete one Release of Information form per person you would like her to stay in contact with about your treatment (i.e family members, current therapist, primary care doctor, etc.)

 Consent to use and disclose your health information
 Welcome Patient information handout
Patient Registration
Health History
Authorization to Release
Credit Card Authorization

Our Smoke-free facilities

Both Knoxville and Loudon offices are smoke-free facilities. Learn the surprising facts about how depression is more common in smokers at www.smokefree.gov/topic-depression.aspx. Also listed there are resources to help you quit.

Medication Refills

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Contacting Mrs. Eby

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