Prepare for your visit by filling out these forms ahead of your appointment and bring them with you. This will help us provide you with an efficient visit. Thank you!

We ask that you please arrive at least 30 minutes prior to your scheduled appointment. Please bring the following items with you to your visit:

• Your current health insurance information 

• Your current Photo ID

• Any medications you are currently taking in their original containers or in a list with dosages and times

Please note: In order to provide efficient care for all of our patients, you may be asked to reschedule your appointment if you do not arrive at least 30 minutes early.

It’s very important that you request your prescription refills during normal business hours before 5 p.m. Monday-Friday. Prescriptions will not be refilled on weekends or holidays.

You can request a refill on the MyCovenantHealth Patient Portal or by calling your pharmacy.

Referrals

Insurers often require a physician referral prior to your visit to Tennessee Heartburn Clinic. As a courtesy to our patients, we will attempt to contact your primary care physician and request a referral. However, it is your responsibility to confirm that a referral has been obtained before you are seen by our providers.

Precertification

If a test or procedure is ordered by a Tennessee Heartburn Clinic provider, our staff will obtain a necessary precertification on your behalf. Precertification for any tests or procedures ordered by your own primary care physician is the responsibility of your primary care provider’s office.