New Patient Packet
New to the practice? Save time prior to your first appointment! Print, fill out and sign the New Patient Forms to bring with you.
No insurance doesn't mean you shouldn't have access to healthcare. RMC Physician Group partners with the RMC Foundation to give access to healthcare to patients facing financial hardships. Print and fill out the Financial Assistance Packet, then return it with all required documentation to:
Patient Account Representative
Rhea Medical Center
9400 Rhea County Hwy
Dayton, TN 37321
Eligibility is determined based on your total family income, size, available resources and assets, expected income, living expenses and medical bills.
If your family income is less than 150% of the U.S. Poverty Guideline, you may be eligible for free care. If your family income is less than 300% of the U.S. Poverty guideline, you may be eligible for discounted services.
Financial Assistance is provided for medically necessary treatment only at Rhea Medical Center and RMC Physician Group. It may not be used for cosmetic or elective services.
Patient account representatives are available to assist you with the completion of this application upon request. If you need assistance please call (423) 775-8563 for an appointment.
Print and fill out this form for records to be released to or from our office. You may drop it off, mail or fax it. Please note there is a fee assessed for the sending of records.
In 2004, Tennessee law was revised to recognize more than one written advance directives for health care decision making: the “Living Will” or “Advance Care Plan” and the “Medical Power of Attorney” or “Appointment of Health Care Agent”.
You can use these documents to let your family and doctor know your decisions for health care if you become unable to decide for yourself. You can appoint someone you know and trust as your health care decision maker to ensure that your choice or decision is honored. You can find more information regarding Advanced Directive here.