Please feel free to download and print any of the forms below to save you time during your visit to the clinic.
New Patient Forms
New Patient History
Informed Consent
HIPAA
Authorization For Care
Job Related Injury
Auto Accident
Athletic Physical
Existing Patient Forms
Job Related Injury
Auto Accident
Athletic Physical
| Monday: | 9:00 - 5:30 | Tuesday: | 2:00 - 7:00 | Wednesday: | 9:00 - 5:30 | Thursday: | Closed | Friday: | 9:00 - 5:30 | Saturday: | Closed | Sunday: | Closed |
Walk-Ins Welcome
Appointment Recommended
203 North Main Street
Eureka, KS 67045
620-583-5060 (Phone)
866-855-5508 (Fax)