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Baptist Urgent Care Patient Forms

 

Click on a link to download patient registration forms prior to your visit. You may fill out the forms and bring them with you to save time. If you plan to visit the Middletown location, you can even fax your completed forms to our secure fax at (502) 238-2805. If you plan to visit the Eastpoint location, you can fax your completed forms to our secure fax at (502) 210-4819.

Baptist Urgent Care Middletown, Eastpoint and Jeffersontown new patient forms

Baptist Urgent Care Westport Road form