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   To expedite the check in process, the following forms are available for you to print out. Prior to your appointment please fill out these forms and bring them with you to your initial consultation. In addition, please bring your Photo Identification and insurance card (if filing with your insurance company). Dr. Fischer is a provider for Medicare and Medicaid only. However, we will file with your insurance company if indicated as a courtesy to you.

Patient Information

Medical History

Acknowledgement Receipt of Privacy Notice

Financial Policies

Notice of Privacy Practices (informational only)

Dr. Kenny Fischer - The Plastic Surgery Clinic - Manhattan Medical Center
1133 College Avenue Building A Suite 211 Manhattan, KS 66502 785-776-7500
PRE APPOINTMENT FORMS