We would like to welcome you to our clinic. If, for any reason, you cannot keep your appointment, please call our office at 859-236-1250 as soon as possible and we will be glad to reschedule your appointment for a more convenient time. Calling to cancel or reschedule your appointment will free up time in our schedule for other patients that may need to be seen at an earlier time.
It is our mission to provide all of our patients with the best quality and the most up-to-date care available. At the bottom of the page, you will see a link for our Authorization for Release of Medical Record Information and Communication Directive Consent for Treatment Insurance Authorization for your perusal and signature. We have also enclosed our Patient Information Sheet paperwork for you to complete prior to your scheduled appointment so that we can expedite your registration process. Finally, please complete the Health History form so we will be able to fully understand your conditions and apply the best treatments possible and our recent services form for female patients or male patients.
If you do not live in Danville, click here for a map and directions to our office which is located on the Family Medicine Clinic of Danville grounds.
If you have any questions concerning our policies please feel free to call us and we will be happy to answer any questions you may have. We look forward to seeing you soon. Once you've filled out the forms, either print and fax them to us at (859) 236-9776, print and mail them to 640 E. Lexington Ave., Danville, KY 40422, or print and bring them with you to your appointment.
Thank you and welcome to
Family Medicine Clinic of Danville, PSC
Form 1: Patient Information Sheet
Form 2: Health History
Form 3: Communication Directive, Consent for Treatment, Insurance Authorization and Assignment
Form 6: Notice of Privacy Practices
Form 7: Authorization for Release of Medical Record Information
Form 8: Practice Brochure