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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.

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