Have a medical question? Are you new to our practice and want more info? Click here to ask us your questions!
Forms & Applications
Patient Forms
- New Patient Form (to request an appointment) | Complete Online
- Full Intake Package*: Download & Print
*You can fill this out in our office but to make your visit more efficient, feel free to complete this intake package beforehand
Referral Forms
- Attorney Referral Form: Complete Online | Download & Print
- Physician Referral Form: Complete Online | Download & Print
- Chiropractor Referral Form: Complete Online | Download & Print
- PIP Application: Complete Online & Print
Attorney Resources
Useful Documents
- WHY CHOOSE KPA?: Get the Details
- Narrative Report Example: Example 1 | Example 2
- We will still refer to a preferred Chiropractor or PT: READ ABOUT A RECENT CONVERSATION WE HAD WITH A P.I. ATTORNEY
- Attorney Referral Form: Complete Online | Download & Print
- PIP Application: Complete Online & Print
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We Help Attorneys Help Their Clients
Supporting Patients and Personal Injury Attorneys
A Conversation with an Auto Injury Attorney
We're Valued by Local Attorneys
Here are details to know if you desire care from KPA:
Appointments
When you come in for an appointment, please have the following information available:
- A valid, government issued photo ID
- Your insurance information along with the claim number for the auto accident
- The name and contact information for your attorney
- The name and contact information for any other physicians you are treating with. For example a Chiropractor or Physical Therapist.
On your first visit, please arrive 20 minutes early and be prepared to fill out our “New Patient” paperwork packet. This will ensure the timely processing of your treatment and medical bills. To make this process more convenient, you can submit the “Patient Demographic Form” online or download and print the forms to fill out at home and bring with you on your first visit!
Transportation
If you are driving to KPA in your own vehicle, we provide free parking in the PARC Garage behind our building. Contact Us for more details.
If you need help with transportation:
- We provide TARC bus tickets for your ride home or,
- We can arrange round trip transportation with 3 days advance notice.To schedule transportation, call (502) 855-3919 ext. 1
