Patient Forms
Streamline Your Appointment Process
Our goal is to streamline your Wichita Nephrology Group appointment process as much as possible. Below are links to some of our most common patient forms. We invite you to view, download, print and complete them prior to your appointment. Medicare patients, please take note of the two additional forms. If you have any questions, please contact us!
We accept all major insurances including, but not limited to, Medicare, Medicare replacement plans and Medicaid.
General Patient Forms
So that we may file your insurance, please fill out the following forms and bring them to your first visit. If you have Power of Attorney or Conservatorship, please bring a copy of the legal document so it can be placed on the chart. Find out what else you should bring to your appointment here.
-
New Patient Forms Packet
This download contains all forms new patients must complete.
Download -
Medical Records Release Form
Download -
New Patient Forms Packet - Medicare
This download contains all forms new patients must complete per the above, in addition to several forms new patients who use Medicare must complete.
Download
Your Appointment
If you already have an appointment, please find out more about how to prepare for your appointment, what to bring, how to get there and what to expect.