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  Patient Forms Packet

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For your convenience, you can download our forms packet. Print, complete and return these pages at your appointment time to speed your check in.
CCE Forms Packet [PDF]
Notice of Privacy Practices [PDF]

 

Patients are seen by appointments in order of appointment time. We have certain appointment slots set up for well checks, advanced appointments and same day appointments. The well checks are for well baby examinations, sport physicals or well child check-ups. The advanced appointments are used for visits that can be scheduled at least one day in advance. The same day appointments open up the morning of the current day for sick children. We serve children birth through college.

Well Child Care
The physicians at Children's Clinic East suggest the following schedule of appointments:
  • Newborn (3-5 days) check up
  • 1 month check up
  • 2 month check up
  • 4 month check up
  • 6 month check up
  • 9 month check up
  • 12 month check up
  • 15 month check up
  • 18 month check up
  • 2 year check up
  • Every year after the 2 year check up
These appointment slots are longer due to the time required for the visits. Please try to schedule the appointments in advance to avoid delays in the above suggested schedule. This includes sports, camp or school physicals.

Telephone Triage
Many times a parent may not be sure if a child needs to see the physician. If there is ever a life threatening emergency, please call 911.
We have a Telephone Triage Nurse available for questions during business hours. This is also a way to get a question to your physician. We strive to return your calls before the end of our business day. Routine refills must be requested during business hours. Please understand it may take up to 24 hours to complete the refill request.

Hospitals
Our physicians admit and make rounds at:
  • Summit Medical Center
  • Baptist Hospital
  • Vanderbilt Children's Hospital/Vanderbilt Hosptial
  • Centennial Medical Center
If your child is ever admitted after business hours or seen at the emergency room please contact our referral line within 24 hours of the visit.

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Referrals
If one of our physicians refers your child to a specialist, our nurses will work with your insurance company to obtain the proper referrals. Please allow 48 hours for the referral process to be completed. If one of our physicians sends your child to the emergency room, please call your insurance company and our office within 24 hours of the visit.

Services Provided
Our office is dedicated to provide quality service to your child ranging from newborn care to teenage physicals. We also provide the following services:
  • Routine Immunizations & Vaccines
  • X-rays (Hermitage office only)
  • Minor laceration repair
  • Various Lab Services
  • Spirometry
  • Audiogram (Hearing screenings)
  • Tympanogram
  • Allergy Injections


photo_billing-records Payment and Billing
We require an insurance card and applicable co-payment or co-insurance for each visit. We accept many major insurance carriers and some TennCare plans. We ask that you be familiar with your insurance benefits prior to the visit. This includes finding out if your plan covers well visits, sick visits and the portion you are responsible for. If you do not know your benefits, we will collect 20% at the time of service. Co-payment will be expected at time of service. If you cannot pay a co-payment for a sick visit, please contact the billing office prior to your visit to make arrangements. Our office accepts cash, checks, Visa and Master Card. If you have any billing questions, please call 615-234-7660.

 

 

  



© Children's Clinic East, PC     615-232-8033   Hours: M-F 8am-5pm; Saturday: 8am-12noon; Sunday: Closed