We’re delighted you want to make an appointment. Contact Ana at 913-642-1900 (voice), 913-642-1901 (fax) or by email
Questions? Information and Policies (PDF) can answer many of your questions. Please review them before making an appointment.
Ready to get started? Please review and complete the following forms and bring them to your first visit.
General Questionnaire (PDF)
For all new patients to complete. Adults will need to calculate their Framingham Risk and enter it on the questionnaire.
Information and Policies (PDF)
Please read this before the first visit.
Children's History Form (PDF)
Please complete if the patient is a child.
Chronic Pain and Headache Form (PDF)
Please complete if pain is the reason for seeing me.
Request for Information (PDF)
This form allows Dr. Klug to request records from or send records to your other physicians. Please complete and send to Ana if you want Dr. Klug to review past lab or other records at your appointment. Ana's contact information is at the top of this page.
Medicare Private Contract (PDF)
Does the patient have Medicare? If so, the patient or guardian must carefully read and sign this contract before Dr. Klug can serve the patient.
