New Patient Forms

Click on the video below before scrolling down to fill out the form.

Additional information to help us better serve you: (If you provided an email when you scheduled, a copy of this will be emailed to you shortly.)

Bring your ID and/or Driver's License with you
Bring your insurance card(s) (Please call if you have any insurance questions (913) 299-0276)
Fill out our intake paperwork by scrolling down and clicking the box to get started
Please call the office to confirm your appointment so we can best serve you on your arrival
If the reason you are coming in is due to injuries sustained in a recent car accident and you are going to file to your insurance, scroll down further.

Motor Vehicle Accident specific information:

Bring your ID and/or Driver's License with you
Bring your auto insurance card (Must be your insurance. We do not bill third party in this office.)
Have claim # with your insurance.
If you have an attorney, please give that info
If you have been to the hospital or another doctor, let us know if X-rays or images were taken. (If possible, please bring these with)
Click the box below and and when selecting the main reason for visit, be sure to select Auto
Please call the office to confirm your appointment so we can best serve you on your arrival

Click the link below if you need a Spanish option