New Patient Registration Forms
Patient Registration (PDF)
Medical History Form (PDF)
Notice of Privacy Practices (PDF)
Patient Contact Information (PDF)
Patient Medication List (PDF)
If you are a new patient, please print and complete the following forms, and bring them with you to your appointment. You will need Adobe Reader to view the forms.
Office Hours
Monday - Friday
9:00am to 5:00pm
Contact Info
Phone:
Fax:
(615) 885-0110
(615) 885-8110
Copyright 2014. Martin H. Wagner, M.D. All rights reserved.