FORMS & NEW PATIENTS

Blood Pressure Log

Telehealth Form

Medical Record Release

Nondiscrimination Notice

Medication Log

New Patient Paperwork

What to bring when you come to our office:

Photo ID Insurance Card(s)
All your current medications including all prescription medications and any over the counter medications and/or vitamin supplements you may be taking. Very important: Make sure to bring them in their original bottles, so we can read the label!
Co-pays are due and collected at your appointment. We take cash, check, credit cards and debit cards but not Amex.

Nondiscrimination Statement:

Cleveland Kidney and Hypertension Consultants, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.