Patient Forms

 

HNS-PatientInformationThe Patient Information Form may be completed online and securely submitted to our office. Click on the form icon at right, complete all fields and click the Submit button.

Please click here to enter your Medical History if you are a new patient to our practice or have not been seen in our offices prior to the addition of electronic medical records. If you have any questions please feel free to contact us at 913-663-5100


HNS-FinancialPolicyPlease download and complete the Financial Policy form at right and bring with you (along with a photo ID) to your first appointment. Click on the Financial Policy form icon to download an Adobe Reader® file of the form.

If you don’t have Adobe Reader on your computer, please click here for a free download.

get adobe reader

 


Notice_of_Privacy_Practices_2013Please download and read the Notice of Privacy Practices. Click on the form icon to download an Adobe Reader® file of the form.

If you don’t have Adobe Reader on your computer, please click here for a free download.

get adobe reader