Patient Forms


Thank you for coming to Brain Health Center. Below you will find the forms necessary for your appointment. If you have any questions regarding the information or which form is right for you, please call our office and we will be able to assist you.


Information for Insurance Authorization

Patient Authorization Form



If you have seen someone else for medication management in the past (or are coming from a hospital/program), we highly recommend providing a copy of your records before our first meeting. This will allow us to review past history and trials during our intake appointment.

Brain Health Center
535 West Second Street, Suite 205
Lexington , KY 40508
Phone: 859-533-9190
Fax: 859-201-1196
Office Hours

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