1. Download**, Print, and Complete the appropriate form(s)
2. Bring your completed paperwork to your appointment
(If unable to print, please fax your completed form to us 502-326-9952)
PLEASE NOTE: If you are not to complete the appropriate forms prior to your appointment, please arrive 15 minutes before your appointment time.
Application for Care
(Required for all adults unless pregnant)
Download & Print Form
Pregnant Patient Application for Care