Online Clinical History Instructions

Our surgical facility must know your health information and medical history prior to your procedure. If this information is not received prior to your date of service your procedure could be delayed or cancelled. Filling out the online form is easy, secure, and essential for you to receive the best care possible. You will receive a text message as soon as you are scheduled at the Center by your surgeon’s office asking to send reminders, please reply YES. After replying YES, you will receive another text with the link to fill out your medical history. If you do not text, call the facility and it can be sent to your email. If you do not have access to the internet, please contact the facility at (615) 575-9000 so it can be noted on your account. A nurse will attempt to call you 1-3 days prior to your procedure to get this information over the phone. If the nurse does not reach you by phone, please, bring in a list of your medications on your date of service and a tablet will be provided at check-in to fill out your medical history in the waiting room.

***If you do not receive a text within a few days of your procedure, please reach out to the Center to verify that we have you on the schedule and have the correct phone number.***

Please fill this out as soon as you receive our text for the procedure.

To prevent cancellation of your procedure.
Do not delay…

It's a simple process…

Please be honest with your responses. All of your medical information is confidential.

The time it takes to complete the form is dependent on your personal medical history. Someone with a more complicated medical history or list of medications will take longer. The average time to complete is 25-30 minutes.

Upon receipt of your information, a staff member or nurse may call you for further clarification. She will go over what medications to take the morning of the procedure. She will be calling 2-4 days prior to the procedure.

NOTE – Once this form is submitted if you come back again we will have your medical history on file and all you will need to do is review for any changes.

What will I need?

Before you begin the online admissions form, please make sure that you have the following information available, as it may be needed to complete your form:

Prescription medications – names and dosage of each one you take.

Over-the-counter medication – names and dosage of each one you take regularly.

Vitamin and herbal medications - names and dosage of any that you take.

Diet Pills or Injections – names and last date taken.

Allergies/Sensitivities you have, and the allergic reaction(s) they cause.

Previous surgeries, and the year they were performed.