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Patient Documents

We have compiled the forms and information you will need for your appointments into easily viewable and printable documents below.  To access the documents click the icon to the right of the needed document name.  
New Patient Medical History Form
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 Microsoft Excel                        PDF

HIPAA and Prescription Policy
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 Microsoft Word                          PDF

Medical Records Release
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 Microsoft Word                         PDF

Demographics
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 Microsoft Word                        PDF

Financial Policy
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 Microsoft Word                       PDF

Medical Consent Form for Minor
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 Microsoft Word                       PDF

Please be prepared for your appointment by having the necessary paperwork filled out prior to your arrival.  Also, be sure to bring your Photo ID, Insurance Card(s) and any current medications including over the counter that you are taking. (bring in the actual pill bottles).
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Note:  You will need Microsoft Word, Microsoft Excel, or Adobe PDF compatible viewers for these documents. 

© 2026 Botts Diabetes and Endocrinology LLC. 

1420 W Baddour Pkwy Suite 200

Lebanon, TN 37087

P: 615-444-4126

F: 855-785-2890

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