805 Burkesville Street, Columbia, KY 42728
Not sure which forms to complete?
Primary Care
If you are coming to our office as a new patient for Primary Care, please complete the Registration Packet and the Patient History Forms - General
Addiction Medicine
If you are coming to our office for Addiction Medicine, please complete the Registration Packet and the Addiction Medicine Patient History Forms
Telehealth
If you have a telehealth visit scheduled with us, please complete the Consent for Telehealth Services form.
Medical Records Request
If you would like to request Medical Records from us, please complete the Medical Records Release Authorization.
HIPAA Release Form
If you would like to give New Path Medical Center permission to speak to someone on your behalf about appointments, medications, etc. please fill out the HIPAA Release Form.
Patient History Forms - General
Addiction Medicine Patient History Forms
Addiction Medicine Patient History Forms
Click the image above to complete the Patient History Forms
Addiction Medicine Patient History Forms
Addiction Medicine Patient History Forms
Addiction Medicine Patient History Forms
Click the image above to complete the Addiction Medicine Patient History Forms
Consent for Telehealth Services
Addiction Medicine Patient History Forms
Medical Records Release Authorization
Click the image above to complete the Consent for Telehealth Services Form
Medical Records Release Authorization
Consent for Buprenorphine Treatment During Pregnancy
Medical Records Release Authorization
Click the image above to complete the Medical Records Release Authorization form.
COVID-19 Testing Registration
Consent for Buprenorphine Treatment During Pregnancy
Consent for Buprenorphine Treatment During Pregnancy
Click the image above to complete the registration forms if you are already scheduled for COVID testing at our clinic
Consent for Buprenorphine Treatment During Pregnancy
Consent for Buprenorphine Treatment During Pregnancy
Consent for Buprenorphine Treatment During Pregnancy
Click the image above to complete the registration forms to Consent to Buprenorphine Treatment During Pregnancy
