"My daughter has been seeing Dawn Barnes since she was born and she's 17 now. She is an amazing practitioner. Love her, but of course anyone who sees her knows what I am talking about."
Becoming a Patient
We are currently accepting new patients into our practice. Thank you for considering us. To become a new patient call us at (423) 602-9545.
When you come to our office for the first time as a new patient, we’ll ask you to complete some initial forms. You are welcome to print the forms located on this page to speed up your intake process.
To make sure there are no delays in care during your first visit experience, please arrive 15 minutes prior to your scheduled appointment to ensure your registration is complete before meeting with your new provider.
Remember to bring:
- Your insurance card
- Valid photo ID
- List of current medications
- Office co-pay
In an effort to respect the time of all of patients, our staff strives to stay on schedule so that other patients do not have to wait.
For patients who are delayed and arrive late for appointment, every effort will be made to see them the same day. However, wait times may apply, or appointments may need to be rescheduled.
Patient Forms
New Patient Paperwork – These forms are for new patients that will be using Allied Pediatrics as their primary care provider (PCP). To save time at your first appointment fill out these forms before arriving and bring them with you.
Notice of Privacy Practices (PDF) – Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad
Recommended Vaccine Schedule – This is the vaccine schedule that the American Academy of Pediatrics and Allied Pediatrics recommends.
Financial Policy (PDF) – This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)
Authorization for Release of Medical Information (PDF) – Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente
Authorization For Alternate Caretakers – Use this form to authorize alternate caretakers to bring children to their appointments at Allied Pediatrics.
Authorization and Consent for Treatment (PDF) – All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
Preferred Contacts (PDF) – Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
Patient Portal
Once new patient paperwork is completed, you can sign up for our portal. Taking a few minutes to register will give you access to valuable information and services provided in a secure and confidential manner.
