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Patient Intake Forms

Once you schedule an appointment with our office, we'll send digital intake forms to you. If you prefer to print out and complete our intake forms by hand, access these 5 PDFs: 

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  1. Patient Information

  2. Consent to Use Virtual Care Tools

  3. Consent to Treatment

  4. Notice of Privacy Practices Policy and Acknowledgement of Receipt

    1. (Note, we just need the last page, "Acknowledgement of Receipt of Notice of Privacy Practices")

  5. Financial Policy

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Contact Us

1350 Terry Dr.
Plainfield, IN 46168-0000

Tel: 317-576-3211

Fax: 317-526-1497

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24-hour scheduling with our AI assistant, Grace

Office Hours:

Tuesdays, 10:00am-6:30pm EST

Wednesdays, 10:00am-6:30pm EST

Thursdays, 10:00am-6:30pm EST

© 2025 by Davis Osteopathic Center, a registered trade name (assumed business name) of Authentic Health D.O., LLC. All rights reserved. Notice of Privacy Practices. Website Cookie Policy

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