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New Patient Forms

Patients of William Permenter, M.D. or Paul Koerner, M.D. please complete these forms prior to your appointment to save time:

Financial Policy

HIPAA Notice of Privacy Practice

Patient Questionnaire

Patient Registration

Authorization for Use or Disclosure of Health Information

CT Disclosure

Patients of Junfeng Wang, M.D.; Linda Smiley, M.D. or Vicki Gatlin, A.P.N. please complete these forms prior to your appointment to save time:

TWC New Patient Paperwork

  • Welcome
  • Patient Testimonials
  • Appointments
  • New Patient Forms
  • Emergencies and Phone Calls
  • Insurance & Billing
  • Locations
  • Prescription Refills
  • Patient Bill of Rights
  • We Care
  • Privacy Policy
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