new patient paperwork
Patient Forms
For Faster Registration, you can download, print, and fill out our forms Prior to your Appointment.
Download Forms
Forms are in the PDF format. You will need PDF software on your computer, although most modern computers sold in the last 10 years come with PDF software out of the box. If yours didn’t, download Adobe Acrobat Reader here.
All materials on this website including but not limited to text, copy, images and photographs are provided for informational purposes only. This website and related materials are not intended to be a substitute for professional health advice, diagnosis, or treatment. | Good Faith Estimate notice
Danville Location
(859) 236-5562
backtobasics89@nullgmail.com
1420 Hustonville Rd., Danville, KY 40422
Lebanon Location
(270) 699-2323
BacktoBasicsLebanon@nullgmail.com
703 East Main Street, Suite B, Lebanon, KY 40033
1420 Hustonville Road
Danville, KY 40422
Tel: (859) 236-5562
116 Lebanon Trade Center Dr.
Lebanon, KY 40033
Tel: (270) 699-2323