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Forms

Consent to Medical Treatment
Authorization to consent to medical treatment at any medical facility in the absence of legal guardian...view


Financial Policy
Patient payment responsibilities...view


Immunication Certificate
Record of immunization history as required by day cares and schools...view


Initial History
New patient medical history and information...view


Patient Consent
Patient authorization for use and disclosure of protected health information...view


Release of Medical Records
Authorization for use and disclosure of protected health information...view


Patient Information
General patient, parent and insurance information...view


School Exam
Required form for all local public schools prior to initial admission...view


Sports Exam
Form required by the Kentucky High School Athletic Association prior to participation with any school sponsored athletic team...view