New Patient Registration Forms
Save Time with Pre-Registration!
We strive to provide our patients with quality care in a timely manner. To help minimize your time in our office, we encourage all new patients to securely pre-register prior to your visit. After making an appointment, you will receive a text or email message from our office. Follow the prompts to complete registration at your convenience on your own device.
If you do not pre-register, you can still complete the forms in office on arrival.
New patients may receive a call from staff to review medical information prior to their visit.
Financial Assistance
Your retina care is important, and we have many options to help ease the burden of financial hardship. Please contact one of our financial counselors to review your options.
If you are uninsured or have high out-of-pocket deductibles, you may qualify for financial assistance based on your income. Read our Financial Assistance Policy below.
If you think you may qualify, please complete our Financial Application below.
We will review your income vs. expenses to see if you qualify for assistance. Please be sure to include ALL the required proof of income and expense documents listed on the last page of the application.
Please submit the completed application by bringing it with you to your appointment, or you may fax or mail the completed form to
Tennessee Retina
Attn: Medical Billing - Financial Assistance
318 Northcreek Blvd Suite 200
Goodlettsville, TN 37072
FAX (615) 320-1213
If you have any questions regarding the application, please feel free to contact our office at (615) 983-6000.
Medical Records Request
If you would like to request for us to send or receive your medical records, please print and fill out the Medical Records Release Form below.
Requests may be submitted in person or may be mailed, faxed, or emailed to the Tennessee Retina Main location at
Tennessee Retina
Centennial Professional Plaza
345 23rd Avenue N, #350
Nashville, TN 37203
FAX (615) 510-8237
medicalrecords@tnretina.com
