FORMS for Patients
Forms:
FYI- You can get results faster if you download and fill in these forms before your appointment. Please drop them by our office or FAX to: 606-678-8368
For All Patients:
Insurance as well as Self-Pay Payment Agreement
HIPPA Release Form
Authorizations for Release of Information (so KBC can get your Prior Images & Reports):
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for Prior Breast Images
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for Prior Breast Ultrasound/Sonogram Images (if you were under 30)
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for Prior BODY (arm, head, chest, etc) Ultrasound, CT or X-Ray Images