Want to be ahead of the game? Fill out and print these forms prior to your visit.
New Patient Forms
- Initial History Questionnaire
- Registration Form – Includes consent for treatment, Financial and no-show policy, and authorized caregiver
- Authorization to Release Information
- Insurance Information
- Authorization to Accompany for Appointment
These forms can be printed out ahead of time and filled out by the parents and teachers. Please take your time and feel free to add as much additional comments as you can.
- Initial Parent Report
- Follow up Parent Report
- Initial Teacher Report
- Follow up Teacher Report
If you need one of these forms from the doctor, please fill it out as much as you can before your visit:
Physical form for your football player or cheerleader
Standard physical form for participation in Indiana High School activities