Patient Forms

When requesting a copy of your medical records, please use the medical release form below. All forms are in PDF format for downloading and printing.

• Medical Records Release Form Lexington Clinic is committed to providing information in a timely manner. For your convenience, please download the medical records release form, fill it out and mail it to Lexington Clinic, Attn: ROI, 1221 South Broadway, Lexington, KY 40504 or if you are a healthcare facility, you may fax to (859) 258-4489. If you have any questions, please call (859) 258-4837.
• Patient Registration/Patient Insurance Form

• First Choice Walk-In Care: Information For Your Provider Form
• KHSAA Eligibility Rules and Parental Permission From Bylaw References
• Patient Account Information Authorization Release Form

Information Forms for Gastroenterology

• Instructions for Colonoscopy Preparation Guidelines
• Instructions for Colonoscopy and EGD Preparation Guidelines
• Frequently Asked Questions
• Instructions for EGD

Radiology

• Instructions for Colon Cleansing Prep