Office Hours
Monday and Wednesday
7:30 a.m. - 6 p.m.
Tuesday
8 a.m. - 6 p.m.
Thursday
7:30 a.m. - 5 p.m.
Friday
8 a.m. - 5 p.m.
Saturday
8 a.m. - 12 p.m.
Forms for Your Visit
(Download & Print)
- Patient Registration Form
- Autism Spectrum Disorder Questionnaire (first visit only)
- Autism Treatment Evaluation Checklist
- Autism Follow-Up Visit Form
- IHSAA Pre-Participation Physical Evaluation Form
- Notice of Privacy Practices
- Aviso de las Prácticas de la Aislamiento
- Worker's Compensation Injury Questionnaire
- Motor Vehicle Accident Questionnaire
Health Information
Fall Creek Family Medicine accepts most insurance plans as well as Medicare. We submit claims to insurance companies on your behalf. If your insurance plan requires a co-payment for an office visit, this is expected at the time of your visit.
Our staff is dedicated to helping you. Be sure to bring your insurance information and any special insurance forms with you to your visit. It is your responsibility to notify us of any changes in your insurance coverage. Please let us know in advance if you do not have insurance, and we will work with you to develop a plan for payment.
You can reach our billing department at 317-621-1705.