To Submit Electronically:
Click the link below from a laptop or desktop.
(Please do not use mobile phones to submit electronically)
Fill out the form.
Choose to either save and print the document to bring in with you to your appointment
OR click the button labeled “here” to submit electronically and follow the prompts.
***If using a different Email Service Provider other than the default Windows/Mac Email provider (i.e. you use Google Mail, Yahoo, AOL, etc.) submit electronically as above and choose other email service following the prompts to sign in to your account.
If you have any questions or concerns please call our office at 816-454-5433 or print out the form to bring in a paper copy.