Find relief: See the rapidly growing list of medical marijuana dispensaries in KY

1215 Southtown Boulevard, Suite 303, Owensboro, KY 42301

TEXT or Call: (270) 570-9535

TEXT or Call: (270) 570-9535

  • Home
  • About Us
  • New Patients
  • Forms
  • FAQs
  • Pay Here
  • Schedule an Appointment
  • More
    • Home
    • About Us
    • New Patients
    • Forms
    • FAQs
    • Pay Here
    • Schedule an Appointment
  • Home
  • About Us
  • New Patients
  • Forms
  • FAQs
  • Pay Here
  • Schedule an Appointment

YOUR HEALTH,
OUR PRIORITY!

YOUR HEALTH, OUR PRIORITY!YOUR HEALTH, OUR PRIORITY!YOUR HEALTH, OUR PRIORITY!

Forms for New Patients

New Patient Forms

To help reduce anxiety during your visit to our medical marijuana clinic, please PRINT and complete our new patient forms before your appointment. Providing your medical history in advance allows our physician to focus entirely on your treatment plan.

Patient Financial Responsibility Form (pdf)

Download

Consent for Treatment (pdf)

Download

New Patient Demographics & Medical History (pdf)

Download

Notice of Privacy Practices (pdf)

Download

Acknowledgment of Receipt of Notice of Privacy Practices (pdf)

Download

Telehealth Consent (pdf)

Download
  • Home
  • About Us
  • Forms
  • FAQs
  • Pay Here
  • Schedule an Appointment

Affinity Botanical Medicine

1215 Southtown Boulevard ste 303, Owensboro, KY, USA

270-570-9535

Copyright © 2026 Affinity Botanical Medicine - All Rights Reserved.

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