Patient Forms

Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact our office at (859) 226-0031. After you submit your request, our appointment scheduler will respond within 48 hours. See below for forms to complete. Established patients may log in to the patient portal to request appointments and update forms.

You may access the following forms to assist us with your care. Please print and fill out the following forms, then bring them to your appointment.

• Registration Form
• Consent to Treat Form
• Telemedicine Consent to Treat Form
• Patient History Form
• Financial Policy

Please download the following pre-treatment instructions prior to your diagnostic test.

• Abdominal, Gallbladder, Superior Mesenteric, and Renovascular Ultrasound Instructions
• Nuclear Stress and Cardiac PET Stress Test Instructions

*These forms require Adobe Acrobat Reader. Click the Adobe logo above to download.