Patient Forms

Patient Forms at Brain Health Center in Lexington, KY

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.

Patient Forms at Brain Health Center in Lexington, KY
Patient Forms at Brain Health Center in Lexington, KY
Information For Insurance Authorization Form at Brain Health Center in Lexington, KY

Information For Insurance Authorization

BHC Release Of Information To Other Form at Brain Health Center in Lexington, KY

BHC Release Of Information To Other

Consent Form at Brain Health Center in Lexington, KY

Consent Form

HIPPA Notice at Brain Health Center in Lexington, KY

HIPPA Notice

New Patients Intake Form at Brain Health Center in Lexington, KY

Intake Form

Release Of Information To BHC Form at Brain Health Center in Lexington, KY

Release Of Information To BHC

Authorization To Release To Anthem at Brain Health Center in Lexington, KY

Authorization To Release To Anthem

TMS Screening Questions Form at Brain Health Center in Lexington, KY

TMS Screening Questions

Tips TMS at Brain Health Center in Lexington, KY

TIPS TMS

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.

Get Directions to Brain Health Center in Lexington, KY

Lexington, KY

  • 535 West Second Street
    (“West on 2nd” building)
    Suite 205 Lexington KY 40508
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535 West Second Street
(“West on 2nd” building)
Suite 205 Lexington KY 40508