CARDIAC SCREENING EVENTS

Upcoming Events Include:
4/16/2008: Dixie High School
4/19/2008: Town and Country Sports Complex in Wilder, KY

You will need Acrobat Reader to view and print the required forms.

TO REGISTER:

Step 1.
Download and Complete the Medical History Form

Step 2.
Download and Complete the Consent Form

Step 3.
Prepay for your screening online using the form below or by advance check.

Note: Due to the equipment needs for the screening, you must pre-pay in order to get a screening. Payment will not be accepted the day of the screening.

Pre-Pay Here:
4/16/2008 Dixie High School	Patient Name: Patient Age: Pre-Pay now with Credit Card, Check or PayPal:
4/19/2008 Town and Country Sports Complex Wilder, KY	Patient Name: Patient Age: Pre-Pay now with Credit Card, Check or PayPal:

Call 859-572-4511 with questions.