New Patient Paperwork

Alliance Health Care offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • The New Patient Health History Form can be completed and submitted on your computer.
  • The New Pediatric Patient Form is a PDF file. You will need AdobeReaderĀ® to view the form.
    • If you do not already have AdobeReaderĀ® installed on your computer, Click Here to download.
    • Download the necessary form(s), print them out and fill in the required information.
    • Bring the necessary form(s) to your appointment.
  • New Patient Health History Form

    Click to Complete

  • New Pediatric Patient Form

    Click to Download

7:30am - 12:00pm
2:00pm - 5:30pm

2:00pm - 5:30pm

7:30am - 12:00pm
2:00pm - 5:30pm

7:30am - 12:00pm
2:00pm - 5:30pm

7:30am - 12:00pm


Alliance Health Care
1710 State Route 121 Bypass North D
Murray, KY 42071
(270) 753-6100

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