Telemedicine Consult Request
We have revamped the system for registration and billing of telemedicine consultations. If you have any problems or questions regarding this newer system, please contact us at 913-588-2226.
Complete the questions below and click "Request Forms" to download the needed forms.
Is this patient coming in for a Follow-up visit or a New Visit for this particular Telemedicine specialty clinic?
[A known patient being seen in a different specialty clinic is considered to be a "new visit"]
New Patient
Established Patient
What clinic do you need?
Behavioral Psychology, ADHD, and Depression
Center for Child Health and Development (CCHD)
Diet and Nutrition
KUMC Child Psychiatry
Other Clinic
Pediatric General
Physical Therapy
Sonnenschein Child Psychiatry
Weight Management
Please note: "USD500" forms are no longer required. They might be listed on the fax cover sheet, but they are not included in the download and are not needed.
If you are confused about this process, visit our
Help Page
.