For Emergencies Call 911 Now - Call UTC Today (859)266-4UTC (4882)

UTC RegistrationPrinter-Friendly Registration Documents

Download our complete 5-page registration package PDF, complete each page, and bring all five to any UTC location to expediate the registration and waiting process!

Download Complete 5-Page Registration Package (PDF)

Or, if you prefer, you may download the individual PDF forms below.

Form 1: Patient Registration Form
Form 2: Medical History and Assessment Form
Form 3: Consent to Treatment
Form 4: Receipt of Privacy Practices Form
Form 5: Non-Covered Release Form

Consent to Treat Minors Form

Privacy Policy