new patient forms

Please print out each of these forms, fill them out and fax them to our office at 502.458.7797. If you do not have access to a fax machine, please be sure to bring them with you on your first visit.

Patient registration and medical history forms

Online Forms

Patient Registration Form

Medical History Form

Sleep Consultation Form

Current Physician List

Latex Allergy and Privacy Forms

Oral Appliance Referral Form

Forms will open in a separate window above this window. When you have printed the forms, closing each window will bring you back to this page.

These forms are available as Adobe Acrobat pdf files. On a slow connection, theymay take a minute or so to load - please be patient. If you do not have the latest version of the Adobe Acrobat Reader it is available as a free download here