Medical & Dental Forms

These forms are provided in a PDF format, and must be printed off in order to fill them out.

 

 

This is the first step in becoming a part of our family

 

These are your rights as a patient

 

For those concerned affordable healthcare, we offer a sliding fee scale for those who qualify.

 

This form is to help us serve you better

 

This form is used to request your records from your previous health provider (we will send it off for you)

 

A helpful guide to see if we have forgot anything

 

 

 

Sports/School and Kan-Be-Healthy Physicals