Our office offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, click here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) 859-781-8701 or bring it with you to your appointment.
This page will allow you to open and print all of the forms that you need to bring with you to your first visit.
During your first office visit the doctor will conduct a thorough one-on-one consultation and listen to your concerns. A complete health history will be taken. A focused or comprehensive examination will be performed depending on your condition. X-rays may or may not be necessary. They are not taken as a routine but taken if indicated. If they are deemed necessary the doctor will take them in the office and review them with you. Your first visit will take approximately 30 minutes, maybe more. If you print the forms below that pertain to you then you will save time in the waiting room.
All new patients need the following forms (each one will open in a new window) please print, complete and bring with you. If you are using insurance please bring your insurance card with you.
- Download New Patient Registration Form
- Download Symptom Diagram
- Download Informed Consent for Treatment
- Download Notice of Privacy Practices – HIPAA (please read, print for your records)
- Download Privacy Policy Acknowledgement Form
- Download Privacy Share Form
- Download Office Billing Policy
- Download Auto Accident / Work Injury Report
- Download Neck Index
- Download Low Back Index
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