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Office Forms

Any necessary office forms can be printed & completed at home and brought to our office upon your next visit. All forms are in PDF format.

NEW PATIENT FORMS:

Patient Profile Form - Please print, complete & bring to your 1st visit

Patient Consent to Treat Form - Please print, complete & bring to your 1st visit

Financial Policy - Please print, complete & bring to your 1st visit

Schools & Daycare Release - Please print, complete & bring to your 1st visit

Transfer Release - Please complete & fax/send to your previous doctor
YEARLY UPDATE FORMS:
Patient Profile Form - Please print, complete and bring to office.
Financial Policy - Please print, complete and bring to office.
Consent to Treat Form - Please print, complete and bring to office.
Schools & Daycare Release - Please print, complete and bring to office.
OFFICE FORMS:

Ky. High School Athletics Association (KHSAA) (Examination Form)

(In order to get these forms back to you in a timely manner, we ask that you print out pages 7-10, fill out the portions you can and then send into us to fill out the remaining information. Allow 2-3 business days for forms to be ready).

Patient Satisfaction Survey Main Office
Patient Satisfaction Survey East Office

Please complete and fax to Administration at 977-0237 or you can go to the survey tab along the left side of page and fill out online.

 

PAA’s Pediatricians

James G. Straub
M.D., F.A.A.P.
Barnett W. Lewis
M.D., F.A.A.P.
John P. Riley
M.D., F.A.A.P.
Sharon D. Menkus
M.D., F.A.A.P.
Charles G. Ison
M.D., F.A.A.P.
W. Robert Revelette
PhD., M.D., F.A.A.P.
Katrina M. Hood
M.D., F.A.A.P.
Michelle L. Bennett
M.D., F.A.A.P.
Brian S. Gillispie
D.O., F.A.A.P.
Daphne T. Hosinski
M.D., F.A.A.P.
Jennifer L. Wilson
M.D., F.A.A.P.

 

 

The physicians and staff of Pediatric and Adolescent Associates, Lexington, Kentucky thank you for choosing us to provide health care to your children. We appreciate the confidence and trust that this very important selection demonstrates. Whether you are having your first baby or transferring a child’s care here from another office, this website will serve as an introduction to our practice. We look forward to a long relationship with you and your children. Our goals are to help you raise your child to be a healthy, well-adjusted individual and to help you to be comfortable in your role as parents.
PAA Fast Facts

 

M-F: 8am-5pm / Sat.: 8am-noon / Sun. & Holidays: Call for Appointment
Main Office: t—859.277.6102 / f—859.977.3033 / After Hours: t—859.276.2594 / Business Office: t—859.276.2005