Save yourself some time and fill out a few forms before you arrive for your appointment. Please click on the forms, print them, fill them out and bring them with you. Questions? Give us a call at 316.688.7500 or email us.

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Finance Your Procedure

 

Printable Forms

• Photo Authorization Form
• Privacy Act
• Medical Records Release (Please complete this form only if you need to transfer your records to us or need us to transfer your records elsewhere.)

Patient forms are available for download in Adobe Acrobat Reader (.pdf) format from this page. This file format is viewable only with Adobe Acrobat Reader software. Click on the icon below to download Adobe Acrobat Reader for free.

 

Physician Certifications