New Patient Forms - Get a head start and download most of the paperwork
Consent to treat minor - Form to bring giving authority to treat when parents not available. This is for anyone under 18.
Request for Records Transfer - Form to request records to or from the clinic.
Cryotherapy Wound Care - After the freeze
Glucose logs - Diabetic glucose tracking
Hypertension Logs - twice daily blood pressure tracking log
HIPAA - Medical Privacy Information from Health and Human Services
Wound Care - For lacerations, surgeries, wounds
Application for disability placard, decal or license plates. 2014 Updated.
Disability forms for parking.
Consent to Treat Minor - Consent form to allow us to treat minors / children
Advanced Care Planning - A Living Will
An Advance Care Plan is a document that tells your doctor how you want to be treated if you are terminally ill or permanently unconscious. You can use a Living Will/Advance Care Plan to tell your doctor you want to avoid life-prolonging interventions such as cardiopulmonary resuscitation (CPR), kidney dialysis or breathing machines. You can use this form to tell your doctor you just want to be pain free and comfortable at the end of life. You may also add other special instructions or limitations in your form.
Appointment of Health Care Agent - A Medical Power of Attorney Form
A Medical Power of Attorney is a term used in the State’s law prior to 2004. In the new law this is referred to as an Appointment of Health Care Agent. An Appointment of Health Care Agent is another type of advance directive that allows you to name a person to make health care decisions for you if you are unable to make them for yourself
An individual, other than a patient’s agent or guardian, authorized under this part to make a health care decision for the patient. May be designated by personally informing the supervising health care provider. May make decisions if patient lacks capacity and no agent or guardian has been appointed. Must follow the best wishes of the patient or act in the best interest of the patient. May not make decision to withhold or withdraw artificial nutrition or hydration.
Coumadin Management Options - Usually divided into 3 options:
Traditional Care - involves a venous blood sample and called 24 hours later with results. This has fallen out of favor with delayed results, higher complication rate, inability to track overdue patients and failure to reach patients with critical results. More hospitalizations.
Point of care - Tested in clinic with real time results, management changes, medication review discussed results, printed directions and scheduled follow up. Fewer complications and less risk.
Self Testing / Self Management - gaining grounds for safety. Use home monitor and follow standard protocols using flowsheets or online calculators to make dose adjustments with 3 month clinic visits
Tennessee Family Medicine
We provide point of care coumadin management for our patients through in-clinic same day testing, results and management with specific printed directions.
Home INR and self care
There has been a recall on the Alere home INR testing devices. Information available here:
http://www.inr-care.com/ww/index/patient-self-tester.html
Information
Cholesterol | Know your numbers - What cholesterol means
Clinic Files and Handouts
Internet Links
Rx Access program saves 25-40%
Help for prescription access if: No prescription drug coverage,
Not eligible for Medicare, and Legal resident of the US or Puerto Rico.
Medicare Part D Plan enrollees:
GlasoSmithKline prescription medication at no cost to Medicare Part D Prescription Drug Plan enrollees who meet eligibility requirements. Please click the link to learn more information.
Medications include Advair Diskus, Altabax, Amerge, Arixtra, Avodart, Coreg, Flonase, Flovent, Imitrex, Lamictal, Lanoxin, Requip, Valtrex, Vesicare, Wellbutrin, Zantac, Zovirax, Zofran and more.
Pfizer Helpful Answers
Helps find assistance programs for numerous Pfizer prescriptions and searches numerous products including Accupril, Celebrex, Chantix, Diflucan, glucotrol, Lipitor, Lyrica, Neurontin, Norvasc, Procardia, Relpax, Viagra, Zoloft and more.
Includes the information about the Pfizer Maintain program and Connection to Care.
Partnership for Prescription Assistance
Another link for group that helps qualifying patients who lack prescription coverage get the medicines they need.
www.diabetes.org - Information from the American Diabetes Association. Includes information about diabetes, nutrition and recipes, weight loss and exercise, local events and more.
Online depression screening.
www.familydoctor.org - A web site operated by the American Academy of Family Physicians, a national medical organization representing more than 93,700 family physicians. Health information for the whole family.
www.bam.gov - Body and mind, a website by the Centers for Disease Control and Prevention, Department of Health and Human Services. Information about fitness, disease, peer pressure, activities designed for kids 9 - 13 years of age.
Benefits Check Up - “Get all the benefits you deserve. Find and enroll in federal, state, local and private programs that help pay for prescription drugs, utility bills, meals, health care and other needs.”
“RxHope is exactly what its name implies...a helping hand to people in need in obtaining critical medications that they would normally have trouble affording. We act as your advocate in making the patient assistance program journey easier and faster by supplying vital information and help.”
Information provided by Vyvanse
“At Merck, we believe that no one should go without the medicines or vaccines they need. That is why the Company provides its medicines and adult vaccines for free or at discounts to people who do not have prescription drug or health insurance coverage and who, without our assistance, cannot afford their Merck medicine and vaccines. This is consistent with Merck's long-held values and traditions of putting patients first.”
Novo Nordisk patient support for Insulin and injections:
“Find help with the cost of medicine
NeedyMeds is a 501(c)(3) nonprofit with the mission of helping people who cannot afford medicine or health care costs. The information at NeedyMeds is available anonymously and free of charge.”
“The Web’s most current and comprehensive directory of Patient Assistance Programs”
Link to Healthspring Medicare Advantage plan.
This is the only Medicare plan that we are currently accepting.
Lilly Cares and LillyMedicareAnswers programs.
Link to Lilly Patient Assistance Programs.
“DrugWatch.com is a comprehensive Web site database featuring extensive information about thousands of different medications and drugs currently on the market or previously available worldwide. DrugWatch.com includes up-to-date information about prescription and over-the-counter medications and includes details about associated side effects to aid in the protection of patients and consumers.”
Gluten Free diet more help - this site comes highly recommended from some of my gluten
sensitive patients. www.Schar.com
Fatty Liver - Information about Fatty Liver disease and risks.
Sleep Troubles - Insomnia is a complicated issue to manage. Start with some simple tips called Sleep Hygiene to improve your sleep habits.
St. Thomas Anticoagulation Monitoring Service
Phone 615-222-4711
4230 Harding Rd. Suite G-6
Medical Plaza West
Nashville, TN 37205
Vanderbilt Hemostasis-Thrombosis Clinic
Phone 615-939-1765
2200 Children's Way DOT 6105
Nashville, TN 37232-9306
Diabetes Information ( New )
Introduction: Basic information for newly diagnosed diabetes. There is much more to learn but this is a place to start.
What should I expect? What are the goals?
What is the treatment? Is there a cure?
Dig a little deeper on how to fine tune your diet and your glucose control to reduce future risks. What are we looking for? What are the complications and how do I avoid them?
MTHFR Mutation information - Information for dietary management.
Eye Exams - Most insurance covers annual eye exams for Diabetes. Be sure you stay up to date. Here are some local suggestions.
Vertigo and Dizziness - If you've been seen for Benign Positional Vertigo in the clinic we recommended some exercises to help. Here is a video to demonstrate.
Explanation of Labs - Explanation of common lab values.
Kidney Stones - Information about kidney stones and prevention.
Proton Pump Inhibitors - Information about medication concerns with reflux drugs.
FODMAP Diet - Information about IBS diet to limit certain sugars. ( copy from University of Arizona)
Body Map - Use the Body Map form to record location of moles, mark areas of pain, or
other areas of concern to discuss at your next visit.
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URGENT
Shortcut | Press Command+F or Control+F to search quickly
Travel Information - Handout provides information about services available at TFM
and those that may require treatment at other facility.
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You told me my glucose / sugar was high, now what? - information for healthy diet.
Pre-Diabetes
Opioid Abuse Help - Substance Abuse and Mental Health Services Administration
Bladder Exercises ( Kegel Exercises )
Calcium and Vitamin D supplements - NEW updated information.
Breakfast Ideas - I get most complaints about what to eat healthy for breakfast. Try these.
Celiac Information- National Digestive Diseases Information Clearinghouse.
Gluten Free Diet - Celiac Disease Information Also visit www.celiac.org for information
Fructose Dietary Information - Important dietary information
Coumadin Handout - Helpful information about coumadin / warfarin and vitamin K
Sore Throat Gargle - Better than just salt and water. More soothing.
Heart CT for plaque evaluation- CT of the heart for evaluation of plaque and heart disease.
Iron Deficiency - Low iron levels, tips and information to increase iron in your diet.
Bone Density Results - How to interpret bone density / DEXA results.
Self Care for Colds - Information on over the counter medications for common complaints.
Mononucleosis - Information about Mono - AKA the “kissing disease”.
Improve your cholesterol - Dietary changes that can help your cholesterol.
Motion Sickness - If you are prone to motion sickness or going on a cruise.
GERD | Gastroesophageal Reflux | Heartburn - Important information
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Travel Information - Handout provides information about services available at TFM
and those that may require treatment at other facility.
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Migraine Headaches - Information about migraines and prevention.
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