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FORMS for Patients

New Patients:

Set up an Appointment: (606) 219-4184 


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​
KBC Privacy Practices & HIPPA Release Form

Authorizations for Release of Information (so KBC can get your Prior Images & Reports):​  
How to access the Patient Portal
Optional Patient Forms:
If You are Pregnant, please fill in: Pregnancy Consent Form
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