Online Referral Form

Doctors are invited to refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Online Referring Doctors Form

Please call the office with any questions or concerns.

  • Get driving directions: Knoxville Office, Maryville Office, or Morristown Office
  • Meet Dr. Shank
  • Request an Appointment
  • Patient Registration
  • Office Hours: Monday through Friday 8:30 AM – 5:00 PM