Poughkeepsie: Tel - (845)454-1399 Fax - (845)397-1333 Newburgh: Tel - (845)561-6191 Fax - (845)561-4145 Kingston: Tel - (845) 340-1000 Fax - (845)340-1002
Copyright © 2017 Advanced Kidney Care - All Rights Reserved.

ONLINE FORMS

New Patient Packet

New patients can save time at check in by printing out the following forms and having them filled out when you come in for your appointment.
Download Patient Demographics Form Download Patient Demographics Form Download Records Release Authorization Download Records Release Authorization Download Notice of Privacy Practices Download Notice of Privacy Practices Download History and Physical Form Download Record Release Form Download History and Physical Form
Poughkeepsie: Tel - (845)454-1399 Fax - (845)397-1333 Newburgh: Tel - (845)561-6191 Fax - (845)561-4145 Kingston: Tel - (845) 340-1000 Fax - (845)340-1002
Copyright © 2017 Advanced Kidney Care - All Rights Reserved.

ONLINE FORMS

New Patient Packet

New patients can save time at check in by printing out the following forms and having them filled out when you come in for your appointment.
Download Patient Demographics Form Download Patient Demographics Form Download Records Release Authorization Download Record Release Form Download Records Release Authorization Download Notice of Privacy Practices Download Notice of Privacy Practices Download History and Physical Form Download History and Physical Form