If you are coming to our office for the first time, there are several items of paperwork that will need to be completed.  By allowing you to complete these forms in advance, we can speed the registration process that takes place upon your arrival.  Simply click, print, and complete each file below, and bring with you to your appointment.

New Patient Packet
Please be patient. This form may take several seconds to load.

For a copy of your medical records, you may download and fill out the release form below.

Please call 901-345-6700 to inquire about corresponding fees.  When payment is made over the phone, you may fax the completed form to 901-345-6755 or email it to tadams@occumedtn.com.

You can also mail completed form with payment to:

OccuMed
Attention: Medical Records
1785 Nonconnah Blvd.
Suite 120
Memphis, TN  38132 

Medical Records Release Form

Please fill out this form for Pre-employment, drug screen, work comp., dot, recertification, and / or resp. exams.

Patient Information Form for Work Related Visits

Important Information About Worker Comp Claims and Payments

Change of Address Form

Robinson & Associates MVA Policy