For your convenience
We’ve collected the various forms and informational materials you may need when visiting our offices. If you have any questions or concerns, please contact us.
Please click on any of the links below to download a pdf copy of the forms to complete before your visit. The requested form will open in a new page, where you can print it or download it to your computer. If you do not have access to a printer, you can stop by your doctor’s office to pick up a copy, or plan on arriving for your appointment a few minutes early to take care of the paperwork.
New Patient
- Sign Me Up for Follow My Health
- New Patient Registration Form
- HIPAA Form
- HIPPA Notice
- OB/Gyn First Visit
- OB/Gyn Follow-up
Wellness Visit
Records
Physicals
- DOT Physical for Commercial Driver Medical Certification
(Please note: CDL’s expire every 2 years. Please be sure yours is up to date!) - Sports Physical Handout
Please read before scheduling your child’s sports physical - Sports Physical
To be filled out by parent or guardian prior to visit
Financial
Assessments
- Connors Rating Scale (ADHD Assessment for Parents)
- Connors Rating Scale (ADHD Assessment for Teachers)
Advanced Directives
- Advanced Directives Brochure
Before completing any of the forms in the following section, we recommend that you review this information about ways you can direct your medical care and treatment in the event that you are unable to communicate for yourself. You can find further information at Indiana State Department of Health’s Advanced Directives Resource Center website.)
