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):​
Optional Patient Forms:
If You are Pregnant, please fill in: Pregnancy Consent Form