MAIN: 859.236.1080 AFTER HOURS: 859.239.1000 BILLING: 859.236.7046
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
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.
Grades 6-8 or Grades 9-12