Ambulatory Registration
For all patients, please complete for your first visit
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Specialty Care
IU Health Precision Medicine Clinic
IU Health University Hospital
Suite 2180
550 N University Blvd
Indianapolis, IN 46202
General Inquiries
Fax Number
Hours
Hours Notice:
This location is open on the first Wednesday of every month from 8:00 am to 12:00 pm.
When you visit IU Health Precision Medicine Clinic in Indianapolis, you'll receive care designed for your specific needs.
Our highly skilled team believes in treating you as a whole person - not just a symptom. At IU Health Precision Medicine Clinic, you’ll have access to a broad range of specialty care services.
Registro Ambulatorio
Para todos los pacientes, por favor completa para su primera visita
General Consent
You will be asked to review and sign this consent to receive care from our physicians and staff
Consentimiento General
Se te pedirá que revise y firme este consentimiento para recibir atención de nuestros médicos y personal
Preferred Communication Form
Complete this form to allow family and friends to receive information regarding your health
Lista de Comunicación de Información Preferida
Complete este formulario para permitir que familiares y amigos pueden reciber información sobre su salud
Authorization to Release Medical Records
Complete this form when you’d like for your medical records to be released to another entity
Autorización para Publicar y Divulgar Información del Paciente
Complete este formulario cuando desee que sus registros médicos sean liberados a otra persona
Email Consent
Review and sign this consent in order to have communication with our physicians and staff via email
Authorization to Treat a Minor
Complete this form to allow family or friends to give medical consent for pediatric patients; this form can also be used to allow minors to give their own consent
Adult History and Physical Questionnaire
For all adult patients to complete for their first appointment and to complete annually
Forms
Ambulatory Registration
For all patients, please complete for your first visit
Registro Ambulatorio
Para todos los pacientes, por favor completa para su primera visita
General Consent
You will be asked to review and sign this consent to receive care from our physicians and staff
Consentimiento General
Se te pedirá que revise y firme este consentimiento para recibir atención de nuestros médicos y personal
Preferred Communication Form
Complete this form to allow family and friends to receive information regarding your health
Lista de Comunicación de Información Preferida
Complete este formulario para permitir que familiares y amigos pueden reciber información sobre su salud
Authorization to Release Medical Records
Complete this form when you’d like for your medical records to be released to another entity
Autorización para Publicar y Divulgar Información del Paciente
Complete este formulario cuando desee que sus registros médicos sean liberados a otra persona
Email Consent
Review and sign this consent in order to have communication with our physicians and staff via email
Authorization to Treat a Minor
Complete this form to allow family or friends to give medical consent for pediatric patients; this form can also be used to allow minors to give their own consent
Adult History and Physical Questionnaire
For all adult patients to complete for their first appointment and to complete annually