We are pleased that you have chosen a Clinton Family Physicians as your primary care provider. This is the start of a long-term relationship with your doctor who will care for you throughout your life. As a new patient, your doctor needs to know more about you, and to make your first visit as easy as possible, we have provided the necessary forms below.

Please print and bring these completed forms to your first office visit.

In addition to filling out these forms, you will need to bring:

  • Current insurance card
  • Photo ID
  • List of all medications you are currently taking – both prescription and over the counter.

PLEASE NOTE: A $25 fee will be applied for appointment cancellations less than 24 hours notice and for no-show appointments.


Please be aware that we are happy to file your insurance as a courtesy to you; however, it is your responsibility to talk with your insurance carrier to understand how your claim will be processed.  If we are not in network with your policy you may be responsible for a larger payment than if you see an in-network provider. For a complete list of accepted insurances, click here.

As always, please feel free to talk with a member of our staff if you have any questions or concerns.

Please note: Our office cannot accept digital insurance cards at this time.  Please print your insurance card to present to our office upon checking in.

Contact the Billing Office

You may contact the Billing Office for questions related to your account or to make payment arrangements by calling (865) 374-5200.

Patient Portal

Click here to access our secure patient portal for easy health information access.