Patient Forms

Please download, print and complete any / all forms needed. These forms contain our medical questionnaire with special emphasis on Age Related Signs and Symptoms.

Please bring these completed forms with you for Review on the day of your appointment.

New Patient Forms	Assessment Forms
New Patient Office Form	Womens HRT Assessment Form
Patient History Form	Mens HRT Assessment Form
Patient Forms
Financial Policy

We are currently insurance providers for
Aetna
Blue Cross Blue Shield
Children's Mercy Family Health Partners
Cigna
Coventry
Health Partners of Kansas
Kansas Medicaid
Medicare
Preferred Health Systems
SoonerCare
Unicare
United Health Care

We are in process of contracting with other insurances, and will file all
insurance claims for in or out of network.
If you have any questions please call 620-251-2400 ext. 11.