Welcome to
Lexington Clinic

Complete your visit intake before you arrive. It takes about 5 minutes.

Your information is encrypted and sent directly to your care team through our secure EHR system.
Select your appointment type:
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Family Medicine / Internal Medicine
Annual wellness, follow-up, sick visit
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Pediatrics
Well-child, sick visit, behavioral health
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Other Specialty
Cardiology, Ortho, GI, Derm, OB/GYN, etc.
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Verify Your Identity
We'll match this to your existing records.
Demographics
Confirm or update your information.
Additional
Insurance Information
We'll verify your coverage before your visit.
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Tap to photograph front of insurance card
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Tap to photograph back of insurance card
Or enter manually
We'll run a real-time eligibility check and confirm your co-pay estimate before your visit.
Medical History
Review and update your current medications and allergies.
Lisinopril 10mg × Metformin 500mg ×
Penicillin ×
No
Yes
Health Screening
These standardized questionnaires help your care team assess your needs.
Consents & Agreements
Please review and sign the following.
Consent for Treatment
I hereby consent to and authorize the performance of medical treatment, diagnostic procedures, and other healthcare services as deemed necessary or advisable by my physician(s) at Lexington Clinic, PSC. I understand that the practice of medicine is not an exact science and that no guarantees have been made to me regarding the outcome of any examination or treatment. I acknowledge that I have been informed of the nature, purpose, risks, and alternatives of any proposed treatment and have had the opportunity to ask questions. I consent to the use of electronic health records for the storage and transmission of my medical information as required for my care. This consent shall remain in effect for the duration of my care at Lexington Clinic unless revoked in writing. I understand I may revoke this consent at any time, except to the extent that action has already been taken in reliance upon it.
I have read and agree to the Consent for Treatment
Notice of Privacy Practices (HIPAA)
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Lexington Clinic, PSC is required by law to maintain the privacy of your protected health information (PHI), provide you with this notice of our legal duties and privacy practices, and abide by the terms of the notice currently in effect. We may use and disclose your PHI for purposes of treatment, payment, and healthcare operations without your written authorization. For all other uses and disclosures, we will obtain your written authorization. You have the right to request restrictions on certain uses and disclosures, request confidential communications, inspect and copy your PHI, request amendments, receive an accounting of disclosures, and obtain a paper copy of this notice.
I acknowledge receipt of the Notice of Privacy Practices
Electronic Signature
Review & Submit
Please confirm everything looks correct before submitting.
Patient --
Date of Birth --
Phone --
Insurance --
Chief Complaint --
Screenings --
Consents --
Submitting will push your intake data directly to Athena. Your care team will see it before your visit.
You're All Set!
Your intake has been submitted to Lexington Clinic. Your care team will review your information before your appointment.
Confirmation LC-2026-04-28471
Submitted --
Athena Sync Complete