1215 Southtown Boulevard, Suite 303, Owensboro, KY 42301

Call or Text: (270) 570-9535

Call or Text: (270) 570-9535

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    • 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!

With the constant threat of hacking and cybercrime, we have made the decision to secure our patients' Protected Health Information (PHI) by using paper charts exclusively. We ask that you print our forms prior to your initial appointment, fill them out, and we will file them under lock and key!

New Patient Forms

Please be sure to PRINT these documents, fill them out, and bring them with you to your first appointment! 

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

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