Here you will find some of our patient forms and policy agreements.  Please PRINT and fill out prior to your appointment. Once you complete them, please email to frontdesk@midpeds.com or fax to 502-244-9575.

PATIENT REGISTRATION FORM

GENERAL CONSENT FORM

VACCINE POLICY

FINANCIAL POLICY

PATIENT HEALTH HISTORY FORM (New Patients Only)

KHSAA Sports Physical Forms (grades 9-12)

https://khsaa.org/forms/ge04-total-requiredge04andoptionalppe01.pdf

KHSAA Sports Physical Forms (grades 6-8)

https://khsaa.org/forms/ms01-total-requiredms01andoptionalppe01.pdf