New Patient Forms

Please use our Patient Portal to complete New Patient forms and Health History forms online.

Medical Records Forms:

If you wish to fax medical record requests, please print the form, complete and fax to
913-338-1311.


Other Forms

Allergy

Dermatology

Family Practice

Functional Medicine Clinic

General Use

Imaging

Neurolog

Obstetrics (e.g. Maternity)

Orthopedic

Pain Management

Procedures

Vaccine Information Statements

Note: If your child received Pediarix, they received DTaP, Polio and Hepatitis B in one injection.