Tennessee > Local County > Shelby > Circuit Court
Subpoena - Tennessee
| Subpoena Form. This is a Tennessee form and can be used in Circuit Court Shelby Local County . |
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SUBPOENA to testify to take deposition duces tecum for medical records* STATE OF TENNESSEE SHELBY COUNTY CIRCUIT COURT Docket Number * (see HIPAA requirement below) You are hereby commanded to summon: Method of Service: Shelby County Sheriff Commissioner of Insurance ($) Secretary of State ($) Other TN County Sheriff ($) Private Process Server Other ($) Attach Required Fees personally to be and appear on at , at in the City of Memphis, then and there to testify and give evidence on behalf of against in the case of This you will in no wise omit, under the penalty prescribed by law. Herein fail not, and have you then and there this Writ. Tested and Issued this __________ day of _______________________________, 20______ JIMMY MOORE FOR AMERICANS WITH DISABILITIES ACT (ADA) ASSISTANCE ONLY, CALL (901) 379-7895 , Clerk By: ____________________________________D.C. HIPAA NOTICE A copy of this subpoena has been provided to counsel for the patient or the patient by mail or facsimile on the day of , 20 so as to allow him/her seven (7) days to: (A) Serve the recipient of the subpoena by facsimile with a written objection to the subpoena, with a copy of the notice by facsimile to the party that served the subpoena, and (B) Simultaneously file and serve a motion for a protective order consistent with the requirements of T.R.C.P. 26.03 and 26.07. If no objection is made within seven (7) days of the above date, you shall process this subpoena and produce the documents by the date and time specified in the subpoena. The signature of counsel or party on the subpoena is certification that the above notice was provided to the patient. __________________________________________ Attorney or Party Signature for HIPAA notice American LegalNet, Inc. www.FormsWorkFlow.com RETURN OF SERVICE OF SUBPOENA I HEREBY CERTIFY THAT I HAVE SERVED THE WITHIN SUBPOENA: By delivering on the ____________ day of _____________________________, 20_____ at ______________ M. a copy of the subpoena to the following Witness ________________________________________________________________________________ at ____________________________________________________________________________________________________________ _______________________________________________ Signature of person accepting service By: __________________________________________ Sheriff or other authorized person to serve process RETURN OF NON-SERVICE OF SUBPOENA I HEREBY CERTIFY THAT I HAVE NOT SERVED THE WITHIN SUBPOENA: To the named Witness ___________________________________________________________________________________________ because _____________________________ is (are) not to be found in this County after diligent search and inquiry for the following reason(s): ____________________________________________________________________________________________________ This ______________ day of ____________________________, 20_______. By: __________________________________________ Sheriff or other authorized person to serve process IN THE (CIRCUIT/CHANCERY) COURT OF TENNESSEE FOR THE THIRTIETH JUDICIAL DISTRICT AT MEMPHIS SUBPOENA VS American LegalNet, Inc. www.FormsWorkFlow.com Attorney/Pro Se Telephone Number Docket No: Defendant Plaintiff
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