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Doctor and Patient interaction

  Patient Forms Packet


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 New Patient Forms Packet [PDF]
Parent M-Chat Development form [PDF]
NICHQ Assessment Scale Parent New Patient [PDF]
NICHQ Assessment Scale Parent Follow-up [PDF]
NICHQ Assessment Scale Teacher New Patient [PDF]
NICHQ Assessment Scale Teacher Follow-up [PDF]
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Authorization for Disclosure of Health Information [PDF]
CCE Youth Transition Policy Letter [PDF]
Notice of Privacy Practices [PDF]


Please call ahead for an appointment when possible. We see patients for all types of appointments including well checks, physicals, sports physicals, sick visits, minor injuries, vaccinations, lab services, same day visits, and any type of care coordination for your child. Same day appointments are available, with call-ahead appointments preferred. We serve patients from birth thru college.

Well Child Care
The physicians at Children's Clinic East suggest the following schedule of appointments:
  • Newborn check-up (3-5 days after birth)
  • 2 week visit
  • 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
  • 24 month check up
  • 30 month check up
  • 3 year check-up
  • 4 year check-up
  • 5 year check-up
  • 6 year check-up
  • Annual check-ups every year thereafter
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
We have telephone triage staff available for questions during business hours. You may call with any clinical questions. We strive to return your calls before the end of the business day. 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.

Prescription Renewals / Refills
  • Prescriptions renewals can be requested anytime of the day thru our secure Patient Portal. If you don't already have an account, please click here to set one up. We will strive to respond within 1 business day of your portal request.
  • You may have your Pharmacy send a renewal/refill request to our office by fax
  • You may call our Phone Triage staff

Our physicians admit and make rounds at:
  • Tristar Summit Medical Center
  • St. Thomas Midtown
  • Vanderbilt Children's Hospital
  • Tristar 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.

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
  • Minor laceration repair
  • Various Lab Services
  • Spirometry
  • Audiogram (Hearing screenings)
  • Tympanogram
  • Allergy Injections

Youth Transition Policy
Transitioning to responsible teen care and into adulthood can be challenging for both parents and patients. Please click here to review Children's Clinic East's process for communicating with teens and parents during these transitions. As always, if you have any questions, please talk with your doctor.

CCE Youth Transition Policy Letter [PDF]

photo_child-in-crate 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   Hours: M-F 8am-5pm; Saturday: 8am-2pm (Hermitage and Mt. Juliet only); Sunday: Closed
* - Some providers see patients in other locations. Please confirm your appointment location before arriving.

Children's Clinic East complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. If you speak a language other than English, language assistance services, free of charge, are available to you. Call 615-773-7277 (TTY) 1-800-848-0298

Children's Clinic East cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-615-773-7277 (TTY) 1-800-848-0298.