Adult History and Physical Questionnaire
For all adult patients to complete for their first appointment and to complete annually
Primary Care
IU Health Primary Care - Indianapolis
4.6 out of 5 stars
Score is an average of all responses to care provider related questions on our nationally-recognized NRC Health Patient Experience Survey.
Learn About Survey
Learn About Survey
Dunlap Building
1040 Wishard Blvd.
Indianapolis, IN 46202
General Inquiries
Fax Number
Hours
Whatever your primary health care needs are, we provide full healthcare services for you and your entire family. Our providers offer your family complete healthcare that you can trust.
In addition to treating chronic illnesses, we provide preventive services to help keep your family healthy. We offer routine wellness visits, nutritional counseling, health screenings and more.
At IU Health, our primary care providers are committed to delivering individualized care and treatment options for your entire family at every stage of life.
From preventive medicine to promoting healthy lifestyles, we offer services that fit your busy schedule.
Our Services
At our practice, we provide all the services you need in one location, including:
- Obstetrics
- Pediatrics
- Travel medicine
- LGBTQ services
- Minor office procedures
- Diabetes management (including retinal images)
- Hospital follow-up
- Pharmacy
- Behavioral health
About IU Health Physicians Family Medicine in Downtown Indianapolis
At IU Health, our primary care providers are committed to delivering individualized care and treatment options for your entire family at every stage of life.
From preventive medicine to promoting healthy lifestyles, we offer services that fit your busy schedule.
Our Services
At our practice, we provide all the services you need in one location, including:
- Obstetrics
- Pediatrics
- Travel medicine
- LGBTQ services
- Minor office procedures
- Diabetes management (including retinal images)
- Hospital follow-up
- Pharmacy
- Behavioral health
From the moment you step into our office, we want to ensure you have a seamless and comfortable experience. During a typical appointment, our care team will do the following:
- Discuss any concerns you may have
- Review your medical and family history
- Check your vitals
- Provide the necessary medical support
- Help you navigate any specialty care
Parking
All patients can park in the Lockefield Garage (951 Wishard Blvd, Indianapolis, IN, 46202) which can be accessed via Wishard Boulevard.
Insurance
IU Health accepts most insurance plans. We recommend that you verify your benefits and eligibility with your insurance company before your visit.
Preparing for Your Appointment
Prior to your appointment, please bring the following:
- Insurance and identification card(s)
- Bring a copy of relevant medical records
- A list of current medications, including over-the-counter medicines and supplements
To ensure that all patients receive adequate time with their provider, it is important that patients arrive on time for their scheduled appointment. If unforeseen circumstances arise and you may be late to your scheduled appointment, please call the office. You may be asked to reschedule your appointment if you arrive 15 minutes or later for your appointment.
My IU Health Patient Portal
The My IU Health patient portal makes it easy for you to navigate to self-schedule appointments with select providers, send messages to your care team, view results and pay a bill.
About Your Visit
From the moment you step into our office, we want to ensure you have a seamless and comfortable experience. During a typical appointment, our care team will do the following:
- Discuss any concerns you may have
- Review your medical and family history
- Check your vitals
- Provide the necessary medical support
- Help you navigate any specialty care
Parking
All patients can park in the Lockefield Garage (951 Wishard Blvd, Indianapolis, IN, 46202) which can be accessed via Wishard Boulevard.
Insurance
IU Health accepts most insurance plans. We recommend that you verify your benefits and eligibility with your insurance company before your visit.
Preparing for Your Appointment
Prior to your appointment, please bring the following:
- Insurance and identification card(s)
- Bring a copy of relevant medical records
- A list of current medications, including over-the-counter medicines and supplements
To ensure that all patients receive adequate time with their provider, it is important that patients arrive on time for their scheduled appointment. If unforeseen circumstances arise and you may be late to your scheduled appointment, please call the office. You may be asked to reschedule your appointment if you arrive 15 minutes or later for your appointment.
My IU Health Patient Portal
The My IU Health patient portal makes it easy for you to navigate to self-schedule appointments with select providers, send messages to your care team, view results and pay a bill.
(English) 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.
Autorización para Publicar y Divulgar Información del Paciente
Complete este formulario cuando desee que sus registros médicos sean liberados a otra persona
Authorization to Release Medical Records
Complete this form when you'd like for your medical records to be released to another entity.
Lista de Comunicación de Información Preferida
Complete este formulario para permitir que familiares y amigos pueden reciber información sobre su salud
Preferred Communication List
Complete this form to allow family and friends to receive information regarding your health
Consentimiento General
Se te pedirá que revise y firme este consentimiento para recibir atención de nuestros médicos y personal
General Consent
You will be asked to review and sign this consent to receive care from our physicians and staff
Registro Ambulatorio
Para todos los pacientes, por favor completa para su primera visita
Ambulatory Registration
For all patients, please complete for your first visit
Forms & Resources
Adult History and Physical Questionnaire
For all adult patients to complete for their first appointment and to complete annually
(English) 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.
Autorización para Publicar y Divulgar Información del Paciente
Complete este formulario cuando desee que sus registros médicos sean liberados a otra persona
Authorization to Release Medical Records
Complete this form when you'd like for your medical records to be released to another entity.
Lista de Comunicación de Información Preferida
Complete este formulario para permitir que familiares y amigos pueden reciber información sobre su salud
Preferred Communication List
Complete this form to allow family and friends to receive information regarding your health
Consentimiento General
Se te pedirá que revise y firme este consentimiento para recibir atención de nuestros médicos y personal
General Consent
You will be asked to review and sign this consent to receive care from our physicians and staff
Registro Ambulatorio
Para todos los pacientes, por favor completa para su primera visita
Ambulatory Registration
For all patients, please complete for your first visit
IU Health Primary Care
Establishing a relationship with a primary care physician is an important step in improving or maintaining your health. Learn more about the care team and how to make the most of your appointments.
Resources
IU Health Primary Care
Establishing a relationship with a primary care physician is an important step in improving or maintaining your health. Learn more about the care team and how to make the most of your appointments.
