Request an Appointment
We gladly welcome walk-in patients in our clinic, but we also accept appointment requests for both clinic and housecall services.
Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact our office at (800) 945-4654 for clinic services or (219) 750-9497 for housecall services. After you submit your request, our appointment scheduler will respond within 48 hours. See below for forms to complete. Established patients may log in to the patient portal to request appointments and update forms.
Patient Registration Forms
Trinity Medical & Housecall Doctor, PC in Highland, Indiana welcomes you to our practice. Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process. If you are coming to the clinic, please be sure to bring all forms with you to your first visit.
- New Patient Registration
- Authorization to Treat
- Medical History
- Current Medication Log
- Patient Referral Form
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.