Eyes on the Mountain - Patient Forms
Eyes on the Mountain

This form is completed by all new patients of Eyes on the Mountain. This document has two pages. Please feel free to print and fill out both pages prior to your examination to expedite your visit.

For patients who have already filled out this form, Dr. Hale will review it with you prior to the examination.


  These PDFs require a free plugin that may have come included with your browser. If you are having difficulties opening these files Click Here to go to Adobe's web site for Adobe's PDF reader.
Contact Us
1807 Taft Highway Suite 9
Signal Mountain, TN 37377
Map It!

Located on Taft Highway across from the W Road in the Walden Commons Center that also includes The Peak Salon, Mountain Family Medical, Mountain Top Wine & Spirits, and Outdoor Nation.



Phone: 423-886-7252
Fax: 423-886-9551
e-mail us

Mon 9:00am - 5:00pm
Tue 9:00am - 5:00pm
Wed 9:00am - 5:00pm
Thu 9:00am - 5:00pm

Friday Appointments Available by Request




Notice of Privacy Practices