FORMS
If you need assistance or have any questions about any of our forms please call the office.
Office forms
New patient forms
Please completely fill out all forms and bring to your first appointment. We ask that you please arrive 10-15 minutes early to give staff time to load your information into our system.
Medical release form
If you would like to have your child's records sent to us or you would like us to release your records to another provider please completely fill out the form, sign, and date.
KHSAA physical form
(grades 9-12)
These are pre-participation clearance forms required by the KHSAA agency to participate in school sports. Please fill out your portion before your appt.
KHSAA physical form (grades 5-8)
These are pre-participation clearance forms required by the KHSAA agency to participate in school sports. Please fill out your portion before your appt.
Kindergarten Entrance form
Kentucky schools require each child first entering a Kentucky public school or entering Grade 6 to present a Kentucky Preventative Health Care Examination Form.
2036 Regency Road, Suite 2
Lexington, KY 40503
859-286-9046