Medical Assessment - Basics
(Form 1 of 6)

(Packs/how much snuff/chewing tobacco/cigars per day)

(drinks per day/week)

(cups or glasses of Coke, coffee or tea a day)

(how many servings per day)

(how much/how many times a day or week)

(drugs used)

Our Location

Erlanger Medical Mall
979 East Third Street
Suite C-0630
Chattanooga, TN 37403

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More Info

If you need additional information, please call us at (423) 267-5677, or send an e-mail to

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