Family Medicine, Millington Dr. Jerry Floyd, MD

:: BIOGRAPHY - DR. JERRY FLOYD , M.D

Jerry Floyd, M.D. is Board Certified by the American Board of Family Medicine

Specialty		Medical School
Family Medicine Patients: Patients of all ages beginning with children that have already completed their immunizations Residency University of Tennessee Heathplex Program, Memphis, Tennessee		Spartan Health Sciences University, Bieux Fort, Saint Lucia Organizations Fellow, American Academy of Family Physicians

:: FORMS

Adult New Patient For adults (age 18+) with a new patient appointment		Frequently Asked Questions HIPAA as it relates to our patients.
Medical Information Release Authorizes Saint Francis Medical Partners - Bartlett to release your medical information to specific entities.		Request for Correction / Amendment to Record Allows you to request a correction / amendment to your medical record.
Medical Release Form authorizing healthcare provider to release your medical information to Saint Francis Medical Partners		Know Your Benefits This pamphlet can assist you in learning about your insurance benefits, including questions to ask your provider.
Notice and Receipt of Privacy Practices (HIPAA) HIPAA requires all patients to complete this form. Describes how medical information about you may be used and disclosed and how you can access this information.		Red Flags Payment Permission Form Form authorizing a patient the use of Medical Flex card, personal credit card, or personal check to pay for the services that they receive at Saint Francis Medical Partners
		Financial Policy Explains payment of services

:: SERVICES OFFERED

:: HOSPITAL AFFILIATION

2986 Kate Bond Rd.
Bartlett, Tennessee 38133
[t] 901-820-7000
www.saintfrancisbartlett.com