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To schedule an appointment at any location, call 812.282.3899

Patient Forms PDFs

Save time by completing all your new patient paperwork before your visit. Just click here to download the forms. Then simply print them out, fill out all the information and bring them to your upcoming appointment.

You’ll also find Our Notice of Privacy Practices included as well. This describes how medical information about you may be used and disclosed, as well as how you can access this information. It’s given to all new patients, and a copy is available upon request.

Note To All Patients:
In accordance with Federal Trade Commission requirements, effective May 1, 2009, our practice complies with the Red Flags Rule that is intended to PROTECT YOU AGAINST IDENTITY THEFT.

We are required to ask our patients to prove their identity by showing a photo ID and by answering certain questions that only you or your family members would know when you contact us by phone. We appreciate your cooperation with our efforts to protect your identity and comply with federal regulations.