2304 Hurstbourne Village Dr
Suite 500
Louisville, Kentucky 40299
(502) 583-3189
Fax: (502) 581-1463
fcg@familycaregroup.com

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Patient Registration

On your first visit to the office you will be asked to fill out a registration form. It is important that the information you provide on your first visit be accurate since this information will be used to establish your medical record and account. You are encouraged to ask the receptionist any questions you have about the registration form.

If there is a change in your name, address, telephone number, insurance, or place of employment it is important that you notify us promptly. This enables us to keep your chart and account up to date.

If you are being referred to our office by another physician or if you have previously been treated by a physician for your current condition, we will arrange to have all pertinent previous medical records forwarded to our office. This will require a written request from you, which we will forward to your previous physician. Having such records available will expedite your care in this office.

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2304 Hurstbourne Village Dr, Suite 500 • Louisville, Kentucky 40299
(502) 583-3189 • Fax: (502) 581-1463 • fcg@adept.net

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